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final diagnosis explanation please
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final diagnosis explanation please

Final Diagnosis:

Liver,needle core biopsy: Inactive chronic hepatitis with fragmented and nodular parenchyma of advanced chronic liver disease

Diagnosis Comment:

The original H&E, trichrome stain, and iron stain, were reviewed.  The needle core biopsy of the liver is a marginally adequate specimen with five portal areas present for review.  The portal areas show no significant expansion by an inflammatory cell infiltrate. The intralobular bile ducts are intact and show no significant cellular injury.  No significant ductular proliferation is  identified.  The hepatic lobular parenchyma is remarkable for fairly extensive hepatocyte nuclear glycogenation.  Significant necroinflammatory activities not identified.  Steatosis is not identified.  The iron stain demonstrates no significant iron accumualtion within hepatocytes or Kupfer cells.  the trichrome stain is relatively pale but demonstrates portal tract expansion by fibrosis as well as a vague nodularity to the overall fragmented speciman. These findings are most suggestive of an inactive cryptogenic cirrhosis.  With the extensive nuclear glycogenation, this most likely represents and en-stage nonalcoholic steatohepatitis.  Correlation with the clinical impression as well as the serologic information and laboratory data will be necessary for accurate assessment.

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8 Comments Post a Comment
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91778_tn?1252558770
Hi, i am so sorry you are having to go through this. I have been looking up stuff trying to figure this out for you. I know you need answers and it seems to be slow tonight. Someone will come along and correct me if I am wrong. But did the doctors mention that you had NASH?? If so here is some thing I found that talks about what to do, how to change life styles, and things such as that. If I am wrong please forgive me. I know this artical is scary, As I too have cirrhosis. Take care, Debi

http://digestive.niddk.nih.gov/ddiseases/pubs/nash/

http://www.gastro.com/html/liverdisease/nonalchoholic_steatohepatitis.shtml
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91778_tn?1252558770
Cryptogenic cirrhosis (cirrhosis due to unidentified causes) is a common reason for liver transplantation. It is termed cryptogenic cirrhosis because for many years doctors have been unable to explain why a proportion of patients developed cirrhosis. Doctors now believe that cryptogenic cirrhosis is due to NASH (nonalcoholic steatohepatitis) caused by long standing obesity, type 2 diabetes, and insulin resistance. The fat in the liver of patients with NASH is believed to disappear with the onset of cirrhosis, and this has made it difficult for doctors to make the connection between NASH and cryptogenic cirrhosis for a long time. One important clue that NASH leads to cryptogenic cirrhosis is the finding of a high occurrence of NASH in the new livers of patients undergoing liver transplant for cryptogenic cirrhosis. Finally, a study from France suggests that patients with NASH have a similar risk of developing cirrhosis as patients with long standing infection with hepatitis C virus. (See discussion that follows.) However, the progression to cirrhosis from NASH is thought to be slow and the diagnosis of cirrhosis typically is made in patients in their sixties.
Hope this helps, Debi
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Avatar_f_tn
Hi,
You probably know that there aren't any doctors on this forum,  If you don't get any response, you are not being ignored, it would mean no one is has any info regarding your post.

Wish you the best.
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Avatar_f_tn
Also, things are pretty quiet around here on weekends. There are a couple of people on the board who should be able to help you out--be patient.
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Avatar_f_tn
Thank you I wondered if I had not posted  correctly.  I was just hoping someone had the same type of problem that could just hit a little bit of information.  To say I am not scared to death would be a lie.  Thank you for your answer.
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Avatar_f_tn
I just returned from getting a blood test done to check on ammonia level.   I have been in the hospital twice since August.  I didn't know my family of friends.  Ammonia level was very high.  98 once and 99 once.

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Thank your help.  I had a lady ask me what my life expectancy was.  I came unglued.  Never thought about that one.  I knew it was bad, but that one got me.
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91778_tn?1252558770
You know I know what you mean. The day I got my results back from my biopsy. I ask the nurse if I was terminal. She shook her head and said I might want to reconsider doing treatment for hep C because of the quality of life. When my dr came in he said I was in early stages od cirrhosis and if we clear the virus I could live a long and normal live. I should have reported the nurse but let it go. Any way I treated and relapsed, I am treating again. With cirrhosis it is hard to clear the virus. So I know what you mean it is hard not to ponder what our fate might be. But I know of several people here on this site that have been in liver failure and was on the transplant list and has now been taken off the list because he is much better. And we have one person here who is a transplant recipient and he is doing fine too. So no ones knows what lies ahead all we can do is keep going and keep the believing that things will find a way. Is you Dr going to try to get you on the transplant list? Mine wants me to start trying to file for disablity. I tried to find some info on the ammonia levels, what are they going to do about that? I wish you all the best, Debi
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