stage and grade of a boipsy

[1oftheclub222]

So I know that the grade = inflamation and stage =  fibrosis/cirrhosis.

How doe the inflamation play into the results?  the more inflamation, the faster your liver degrades?  

[eureka254]

You are right that blood comes in through two sources for the liver, but what's amazing is even during inflammation and fibrosis development, blood continues to flow and get processed... liver has amazing compensatory mechanisms.  However, as Hector described, when the architecture changes with developing cirrhosis, the liver gets stiff, and it's at that point that blood circulation starts to get compromised, but rarely before that point.  

When cirrhosis sets in, liver dysfunction and circulatory changes within and around the liver start to happen (often called 'decompensation' and 'portal hypertension' respectively)... that's why many people progress to cirrhosis without knowing because symptoms often don't set in until well into Stage 4.  Hope that helps. ~eureka

PS:  Inflammation is not necessarily correlative to amount of damage... it's a response mechanism... collagen production and fibrotic progression in response to inflammation varies greatly from person to person.

[1oftheclub222]

Thank you hector for your explaination, I just saw it today,  that really did help...I kind of had it all wrong, ha...but now that you explained it, it makes perfect sense

[uncledudeness]

hector thank you for your answer; in fact, all of your responses. my biopsy stated at least stage 3, however stage 4 could not be ruled out, as stated in the biopsy response. i had an ultrasound but when i asked if it showed cirrhosis, my NP said she couldn't tell. i am really confused about this and i haven't been able to get a straight answer from her. when asked, she backs up her finding by my low platlet count. it was at 87k when i started tx. it has since dropped to 63k, 47 weeks later. i also have fatty liver and it was enlarged at the time of the ultrasound.

can you share your thoughts on this...


thanks.

[HectorSF]

Inflammation is caused by something that injures the liver. I.E. hepatitis C, alcohol, etc. Inflammation leads to fibrosis (the stage of liver disease). So the more inflammation the more fibrosis is created. When the injury is chronic (as with hepatitis C), collagen builds up and leadis to scar formation. As scarring progresses from bridging fibrosis to the formation of complete nodules it results in architectural distortion and ultimately liver cirrhosis.

This is the difference between fibrosis and cirrhosis. When a person has stage 4 liver disease, cirrhosis, the architecture of the liver is changed. That is why it can be seen on an ultrasound. Degrees of fibrosis can not be seen of diagnosed using a ultrasound. Of course the gold standard for diagnosing and stage of liver disease is still the biopsy here in the US.

So that is an overview of the process from something injuring the liver, to fibrosis and then over many years to cirrhosis. In away it is ironic that fibrosis and cirrhosis are created as part of the wound healing process.

Hope this helped.
Hector

[1oftheclub222]

Thank you

[hrsepwrguy]

This is an 8 page article on liver biopsy it is pretty in depth and covers aspects of stages and grading.

http://www.medscape.com/viewarticle/501268

[1oftheclub222]

Just trying to understand how the live works...so the blood comes in through the portal vein and hepetatic artery, gets processed in the liver and goes back out veins to the body?

so grade/inflamation covers the vein/ arteries and how  well the blood can flow in and out of the liver and the stage covers how your liver can process or filter your blood?