liver biopsy results

[oskar123]

hello my name is oscar thank you for takeing my question, the summary reports says portal periportal necroinflammatory activity  2/4      lobular necroinflammatory activity  2/4 fibrosis and cirrhosis 2/4  number of portals 5.  total length of biopsy   12mm      microscopic    sections of liver core biopsy reveal intact lobular architecture with portal and focal fibrosis minimal fatty change and focal hepatocelluar necrosis.there is a mixed inflammatory portal infitrate consisting mostly of mixed lymphocytes.there is no evidence of parenchymal iron deposition [iron stain] there is no evidence of alpha -1-antitrypsin deficiency [pas stain]. trichrome and reticulin stains reviewed.  am 52 years old i had this virus for 25 to 30 years  take supplements fish oil supplements for the liver and try to get in decent shape. just had my biopsy on march 1 2012     allready had a appoinment with my doctor just wanted another expert advised  thank you for your response.

[twitty_bird]

hi dr. chandra, im from the philippines and also a registered nurse. I have a pending petition from the U.S, i know that i have to do medical test including hepa b, my question was, Is there a possibility that they will approved my petition, even if they found out that im hepa b carrier?  

[Poorna Chandra, SMD, DM]

Dear oskar123,

Thanks for writing back.

Liver cells are arranged in a number of subunits called lobules. Each lobule is a functional unit and has liver cells, blood and bile channels arranged in a definite fashion. This arrangement is very essential to the normal functioning of the liver and progressive liver damage obliterates this architecture.

In your case, since the damage has not so progressed,  the architecture is maintained  or is intact ('intact lobular architecture').

The infiltrate at the portal area of the lobule in Hepatitis C virus infection has a mixture of immune cells like lymphocytes, plasmacells and neutrophils depending on the stage of the disease and this is reported as a 'mixed inflammatory infiltrate'.

Hope I answered all your questions. Please accept my answer in case you do not have further queries. Wish you Good Health.

Best Regards,
Dr Poornachandra

[oskar123]

thank you dr for your response, by the way dr i have hep c not b and i wanted to know also about what they mean by mixed lympocytes  intact lobular architecture   and other written words on the report. and yes dr i had treatment 5 years ago  but only lasted 4 months side effects too much to handle. am thinking maybe next year trying again. my doctor just advised me just take care of my self no drinking beer and it will be alright. but am looking to find a specialist to advise me how my liver overall.  thank you dr

[Poorna Chandra, SMD, DM]

Dear oskar123,

Thanks for writing in.

I presume that when you talk about virus, it is hepatitis B that you are talking about. Your biopsy picture is suggestive of ongoing hepatitis and liver injury. Traditionally, this inflammation is usually associated with elevated liver enzymes. However, in ~25% of the people, the enzymes can be normal due to unknown reasons. In liver biopsy, an inflammatory score of 2 and fibrosis score of 2 is significant and can be an indication for treatment even if the liver enzymes are normal. Hence, discuss with your doctor the merits and demerits of the treatment and decide on the future course of action.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Poorna Chandra K.S