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Liver Lesion, HepB, early cirrhosis, Thalaseemia.
I am a male 58 years of age. In my early years from 1985 -87, i used to drink alcohol. But stopped in 2002.

In 1988/9, due to work stress, i had stomach pain and jaundice and was hospitalised. Then i found i was a Hepatitis B carrier. I actually had hellicobacter bacterial, but the doctor thought it was stomach ulcer due to stress. My hepB flared up, and i had ultra scan and treatment to bring down my jaundice and hepB.

Later in April 2000,, HepB falred up again, and AFP raised to 444. I did CT sccan and no focal suspicious mass seen in the liver. Small cyst in segment 4. No focal enhancement to suggest hepatocellular carcinoma.
I had duodinal bleeding and did an OGD. But the bleeding had stopped early and the wound had healed by itself.

In Dec 2000, HepB flared up again, and ultra sound showed coarse echogenicity but smooth margins which is consistent with early cirrhosis. The spleen shows normal echo pattern. There is no hepato-splenomegaly or focal lesion detected. The portal venous flow is in the normal direction.
I was treated for hellicobacter-bacterial, but somehow, it came back again after one year.
Later, CT scan showed no focal lesion detected. No intra hepatic duct dialatition. No calcified gall stone. Spleen, kidneys pancreas normal. Lung bases are clear.

In 2003, i did a kolonoscopy and found no problem.

In 2004, my stomach pain persisted, and i was given treatment for hellico-bacter bacterial. This time round, the treatment was effective and i had no stomach pain thereafter.

From 2004 - 2009, with the exception of my lower back spinal pain which is due to early year injury, i am seemingly free from any more problem from HepB flare up, stomach ulcer pain, or any other ailments since then.

Recently in Nov 2009, i went for a health screen test, and the doctor was alarmed to notice that my AFP was high  ( 28 ur/L) and my platelets were low at 114 ( haemoglobin is slightly low at 12.4.  Further blood test found me to be a Thalameesia minor. I was required to do CT liver scan, and the results were disturbing.

CT Liver
History: Chronic viral hepatitis B, raised AFP    
CT Abdomen - Triphasic
Axial images were acquired with intravenouis and oral contrast. There is no previous scan for comparison.
The liver appears normal in size with a nodular outline.
A small poorly marginated hypervascular lesion measuring approx 1.8 x 1.5 cm series 6 image 39 is seen in segment 6 on the arterial phase.
On the portal venous phase it appears hypodense suggesting washout.
Tiny cyst seen in segment 8.
Gall bladder is distended and its wall is not thickened. The bilary tree is not dilated
The hepatic and portal veins are normal. Few collaterals are seen along the gastroesophageal junction and gastric fundus.
The spleen, pancreas and adrenals also show normal features. Both kidneys also show normal features, save for tiny left renal cyst.
Visualised loops of bowel show no significant abnormality.
No other abnormal masses nor lymphadenopathy is detected. No evidence of free intraperitoneal fluid or gas.
Mild bronchiectatic change are seen in both lung bases.
No overt bony destruction seen.

Impression:
1. Small poorly marginated lesion segment 6 hypervascular on artierial phase with washout on portal phase suggestive of small hepatocellular carcinoma.
2.Nodular hepatic outline with collaterals adjacent to gastroesophageal junction and fundus in keeping with chronic liver disease.

The doctor suspects that i have liver cirrhosis and liver cancer at early stage, and have asked me to prepare for MRI to confirm, and if so, to prepare for liver transplant.

Please give me your expert second opinion.

Knightc
***@****

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Avatar universal
Right now i dont feel anything wrong with myself.
I do not suffer most of the normal symptoms of cirrhosis and liver cancer.
No nausea. Fatique, yes, but i do a lot of power naps. No weight loss ( Height 174cm, Wt 81kg, BMI 27.5). No jaundice. No liver swelling. No abdominal pain. Yes, i have body itching. no vomit of blood. no ascites. no mental confusion. no coma. no body / hand /leg skin problem.  toe rashes ( now cleared after soaking in diluted antiseptic disinfectant liquid for few weeks.
Anyone with similar symtoms please advise.
*******************(@)gmail.com

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