Can anyone explain these results to me? I am worried.

[gtrembley]

Moderate steatosis with mild steatohepatitis
Grade 3 fibrosis

COMMENT:
Iron stain shows no increase in stainable iron. PAS stain shows no diastase
resistant globules in the cytoplasm. Trichrome stain highlights fibrosis
present. There is focal nodule formation although there is not frank cirrhosis.
There is Mallory hyaline present.


Can anyone explain how bad this is?  My doc says it is at stage 3 of stage 4, 4 meaning cirrohsis.
They also just did a new procedure today called a fibroscan and the nurse said it shows F1 or mild fibrosis.  I haven't talked to the doc on this one yet.

[gtrembley]

Well I see my gastronentologist on Friday, so I will see if he wants to do any more testing.  I will definitely follow up with you.  

See that is the thing about my platelet count, it has been low for over a year, but yet they show my portal vein as being only 3 mm, which is normal, and my spleen is unremarkable, last time it was checked.  Why is this?  Can you explain what might be going on there?  The only things that are abnormal are my A/G ration (1.9), potassium is low, my C-Reactive Protein was high, my D-dimer quantity was high, my platelet count is low, and the other things I told you earlier.

I am so appreciative of your help.  You have explained a lot of things the doctors don't bother to explain.

[fntn]

I don't think your previous fibrosis/adhesion issues you've had relate to your liver problems. Liver fibrosis is a reaction to a direct liver insult. But given your concerns (which are reasonable), I'd try to pressure your doctor into another followup US or maybe a MRI, just for reassurances.

If your bilirubin is normal, your off color isn't jaundice. You have to have a bilirubin level of 2.5 or higher to get to an icterus state. But anytime you get a new set of blood work testing done, feel free to touch base with us, and we can help out.

[gtrembley]

I have not had an MRI, but they did do an Ultrasound over a year ago, after this is when he ordered the biopsy.  Since that time I have only had the Fibroscan.  The biopsy report is what I posted and it does not show varices or PHT, but I am concerned it may now.  I also had scar tissue removed over 30 years ago that had grown from my fallopian tube across to the abdominal wall attaching the intestine to the wall and have had fatty tumors removed from my arm, so I am real prone to excess tissue growing in my body.  Do you think this would increase my chances of the fibrosis becoming worse?  Oh, and I have been suffering with swollen feet and legs, even while taking Lisinopril, I do this in the summer but not this early in the year.  I had DVT twice when I was in my early 20's, both times in the right leg, so almost every summer I wind up getting an ultasound doppler done on my right leg.  I have noticed yellowing in my eyes, although by bilirubin is normal, so I am all kinds of confused and worried about what is going on.

[fntn]

Again, keeping in mind that the sampling maybe correct or maybe not, it's safe to say you're likely near the advanced fibrosis to early cirrhosis stages. Some people with early cirrhosis are able to improve with some regeneration and reduction of their fibrosis by a stage or two. But people with advanced cirrhosis - hardened island nodules with changes in architecture that are surrounded by very dense bridging fibrosis - are not able to reverse things. Your liver may have regions of stage-3 or -4 fibrosis, mixed with other regions of frank cirrhosis.

A reduction in platelets is expected as the portal hypertension (PHT) increases in cirrhotic patients. PHT is caused by the portal blood flow meeting with resistance as it tries to move through the diseased, fibrotic and compressed tissues. This increase in portal pressure enlarges the spleen, resulting in platelet sequestration. The pooling may drop the red and white blood cell counts. And yes, your hemoglobin may drop slightly as well.

Have you had an US or MRI to look things over? In particular, did they see any signs of PHT? Usual signs are: enlarged spleen, large portal vein diameter, ascites, varices, recanalized paraumbilical vein, etc? I have PHT and my spleen is 18 cm with a 16 mm diameter portal vein. So if you do have clinically significant PHT, they should be able to see it.

I'm not a doctor, just an advanced ESLD patient. Dee, myself and others have picked up knowledge along the way while doing battle with our various chronic liver diseases. Hoping that you can improve your circumstances and not have to deal with this not-so-fun stuff. Good luck and let us know how things are going with you.

[gtrembley]

Is this reversible, or will it continue into cirrhosis?  You seem to know what you are talking about, are you a doctor?  I am concerned because my enzymes show normal, but my platelet count keeps going down, it is at 109 last time it was checked about 3 weeks ago and there are some other areas of concern with my hemaglobin dropping, still normal, but slowly declining as well as the size of my red blood cells.

[Dee1956]

Hello! FNTN has given you great advice.  I am a fellow patient, I would trust the biopsy.  The fibroscan doesn't seem to be as reliable for the people I have seen on here.
You do have the ability to change this by changing your diet.
Take Care
Dee