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enlarged liver question
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enlarged liver question

dear community,

when a liver is a bit enlarged,does that mean one have cirrhosis?
i became my report from my hcc screening and it was negative.and all lab results are in the norm.
but they wrote "liver homogenous, 2 fingers under the costal arch palpable,no ascites no enlarged spleen,and i wonder if this mean i have cirrhosis.

i apreciate some answers
regards marc
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I don't believe that an enlarged liver is necessarily cirrhotic. When the liver is inflamed it swells. As a liver becomes scarred (cirrhotic) it shrinks becomes hard.

I should not have suggested that cirrhosis can't exist in an enlarged liver. I don't it is typically seen in HCV caused cirrhosis but it is possible for cirrhosis to be associated with a normal, enlarged or small liver. My personal experience with cirrhosis has been that the liver is small and hard but that's not always the case.

An enlarged liver may occur as a result of one or more of these causes.

Inflammation or fatty liver may cause an enlarged liver and may result from:

    An infection such as a from a virus or abscess
    Certain medications
    Certain types of hepatitis, including alcoholic hepatitis
    Autoimmune disease
    Metabolic syndrome
    Genetic disorders that cause fat, protein, or other substances to build up

Abnormal growths may cause an enlarged liver. This may result from:

    Tumors that start or spread to the liver

A problem with blood flow can cause the liver to enlarge. This may be due to a variety of conditions such as:

    Congestive heart failure, a condition where the heart fails to pump blood well
    Hepatic vein thrombosis, a blockage of veins in the liver
    Veno-occlusive disease, a blockage of small veins in the liver
the also wrote my liversynthesis is at child scora a with 5 points.

do i have still the chance that my liver can regenerate if i rerach svr and iam in an early stage of cirrhosis?
The typical pattern is for the liver to swell somewhat during the early stages of inflammation, but then as it progresses the liver shrinks and hardens. Another clue is the texture. A cirrhotic liver is heterogenous, not homogenous as your report indicates. It really takes a biopsy to be sure whether one has cirrhosis, but there is nothing in your report that sounds like cirrhosis.
I think if your liver is still homogenous in texture that you have a good chance it will regenerate itself. My understanding is that it always tries to regenerate, but it can't do it as effectively when the scarring (nodularity and heterogenous texture) is more extensive as the little pockets of regenerated tissue can't connect well to each other and blood flow remains impaired. I hope I will be corrected if any of that is wrong, but I think that is how it works (simplified, of course).
Hi Marc.

"When a liver is a bit enlarged,does that mean one have cirrhosis? "
No, As troll pointed out it is an indication of inflammation of the liver. If you have inflammation is is probably caused by hepatitis C. Inflammation leads to fibrosis. When the scarring of the liver is complete it is stage 4, cirrhosis. I order to know what stage your liver disease is you need to have a biopsy. As mike said "cirrhosis to be associated with a normal, enlarged or small liver."

"2 fingers under the costal arch palpable"
A normal sized liver is palpable on inspiration about 2-3 cm below the right costal margin. So yours is a little larger than normal.

You need a liver biopsy performed to determine the degree of liver disease and the amount of inflammation you have.

Doctors need a reliable way to quantify what is seen under the microscope when looking at a biopsy sample. The Metavir scoring system assigns two standardized numbers: one to represent the degree of inflammation & the other the degree of fibrosis.

The activity, which is the amount of inflammation (specifically, the intensity of necro-inflammatory lesions), is graded on a 4-point scale from A0 to A3.

Activity score:
A0 = no activity
A1 = mild activity
A2 = moderate activity
A3 = severe activity

Fibrosis score:
F0 = no fibrosis
F1 = portal fibrosis without septa
F2 = portal fibrosis with few septa
F3 = numerous septa without cirrhosis
F4 = cirrhosis

NOTE: There is no correlation between the two.

"Fibrosis Progression Explained

Inflammation (something actively bothering the liver) can lead to fibrosis (abnormal fibrous bands in the liver).
The fibrosis usually begins around the portal tracts (portal tracts are located at the corners of each liver lobule).
As time goes by... (if the inflammation continues).... more and more fibrosis forms.
And eventually---> the fibrosis "bridges" across the lobule (from portal tract to portal tract). (Bridging fibrosis.)
Picture a hexagon shaped lobule. Fibrosis beginning at each corner of the hexagon....
Later, if the fibrosis also forms between those corners -- (like connect the dots) -- that's "bridging fibrosis".
As more time goes by... (if the inflammation continues).... more and more bridging fibrosis forms. (Fibrosis around the portal tracts, fibrosis bridging across the lobule, fibrosis more or less "encircling" the lobule...)
As more time goes by--- Liver cells may begin to die ("necrosis")...
Scar tissue begins to form ("cirrhosis")."

"no enlarged spleen" means you don't have portal hypertension which develops in time as cirrhosis progresses from early compensated cirrhosis with no portal hypertension, to compensated cirrhosis with portal hypertension (enlarged spleen, reduction of platelet count, varices, thick scarring resulting in regenerative nodules in the liver, etc)

Get a referral to a gastroenterologist (digestive disease specialist) and they will be able to diagnose your liver disease and provide any treatment you may need. Make sure they are experienced in treating hepatitis C patients.

Best of luck to you!

Hey guy, your at the end of your treatment, your odds are very good you will soon be SVR. After that in time your liver will heal as your damage is not beyond that point... Relax as soon this will be all over........ Hang in there.
Thanks for all rhe Infos and answers.I think I have to finish this treatment and then hope my liver still can heal.I think also that I should do a biopsy,after the treatment to know what condition my liver is.
its all  just so scary sometimes.
I had an enlarged liver one month and normal size again a couple of
months after. That was before tx. I was told your liver size can change
even under normal circumstances.
Given that you are at the end of your
tx it would not bother me. Just think of all the meds your liver has to process.
My ALT was 70 @ the end of tx caused by the tx meds so I am
not surprised to see someones liver slightly enlarged.
As can-do wrote , relax it will soon be over.

thanks again for all the helpfull postings

are here in this forum people that were cirrhotic before treatment and now expirience a healing of the liver?
I don't know if I was cirrhotic as my doctor said that doing biopsy was optional because of very lowly elevated liver enzymes (VL 2.2 mil, had it for more than 20 years).

As soon as I took the first two week shots of interferon, I experienced that body just under upper right rib cage shrunk dramatically as if it is suctioned from inside. My friends also noticed it and asked I am working out crazy :).

I told my doctor about this, he says that shows that medicine is reducing the liver sweeling by attacking the virus. I am in my 23rd week of triple therapy, liver remains shrunk. My doctor told me that liver would heal and rebuild itself when the virus is gone.
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