need advice with my confusing analysis of result...

[Nani_komo]

march-2014
hbv viral count by taqman method- 6200 iu/ml
hepatitis Be antigen- non reactive
patient value- 0.28
serum urea- 30.0 mg/dl   (20-40) method -dam
serum creatinine- 1.0 mg/dl   (05-1.2)
SGPT and SGOT normal ( within range)
*started taking enticavir....

febuary-2015 after 1 year
hbv viral load below 20 iu/ml
sgot(ast) - 59u/l  
sgpt(alt) - 70 u/l
ultra sound report-
liver- normal size, there is difusse coarsening of parenchmal echo texture. no focal lesion
spleen- mildly enlarged
*medicine- entacavir (conti..) and urdohep for 1 month

#19th march 2015
consulted another doc specialist in liver..
ct scan report - mildly enlarged with normal outline and echotexture.
Impression- mild hepatomegely
sgpt- 39 iu/l  (5-40)
sgot- 43 iu/l  (8-37)
haematology test results all normal

#june 2015
1) ultra sound report-
-liver mildly enlarged with normal  out line and echotexture.
-mild hepato-splememogaly
-small hyperchoic lesion in segment VII of liver likely hemangioma.
2)serum creatinine- 1.0 mg/dl  (0.5-1.2)
-serum sodium- 125m.eq./l  (136-149)
-serum potassium- 3.3m.eq./l  (3.8-5.2)
-serum chloride- 100 mmol/l  (100-106)
-alpha feto protein(AFP) - 1.52 normal ( male: 0-15ng/ml)
-coagulation studies-
prothrombium time test(clot time in sec) - 21 sec (unit-sec)
control - 12 sec (unit-sec)
INR- 1.75  (2.0-3.5)
-carcino embryonic antigen- 1.44 ng/ml (normal)
-CA 19-9 -  8.23(normal)   <1.2-30.90 u/ml
-HBV viral load- below 20 iu/ml
- sgpt- 59
-sgot- 56
* ct scan, 128-slice MDCT of upper abdomen(contrast)- continous spiral sections of the abdomen were taken in both arterial and venous phase from the level of diaphragm to the renal hilum.
report-
-liver is mildly enlarged with normal attenuation. small hypodense lesion is seen in segment VI of liver measuring 12×12 mm. the lesion shows nodular peripheral enhancement with centripetal filling without rapid washout of contrast. hepatic vein and IVC are patent. perihepatic spaces are normal. portal vein at confluence including its proximal and left main branches are prominent.
-impression:
-mild hepatomegaly with a small space-occupying lesion in segment VI with imaging morphology as described- suggest hemangioma.
-prominent intra abdominal lymph nodes- likely to be reactive
- no significant ascites.
* medicine prescribed by doctor,
- enticavir (continue)
-  s-adenosyl methionine tablets 400mg
- maxiliv tablet
  
question-
1) any relation of hemangioma with  hepatitis? what could be the cause? any chance of increase in size? what should i do?
2) why s-adenosyl methionine tablet is prescribed?
3) am i non-active carrier, if yes can i stop entacavir? if stoped any chance of negative effect on liver or viral load.?

[twinboys1girl4me]

No medication for a liver hemangioma.  If they get huge they may resect liver (and liver grows back/regenerates on own) but most times they do not grow or cause any issues.  Below are some sites that give good information.

http://www.medicinenet.com/script/main/mobileart.asp?articlekey=9576

http://www.nlm.nih.gov/medlineplus/ency/article/000243.htm

http://www.mayoclinic.org/diseases-conditions/liver-hemangioma/basics/definition/con-20034197

[Nani_komo]

is fibrosis a serious case?? how can i know though fibroscan that i have fibrosis??

[Nani_komo]

has doctor prescribed any medicine for hemangioma?? can it be cured??

[twinboys1girl4me]

Also, a hemangioma has nothing to do with hepatitis.  Many have them without liver issues.

[twinboys1girl4me]

As far as the lesion, I recently had this happen.  In January they found a hyperechoic lesion from ultrasound .  I had a CT scan in March with contrast and a MRI last month, both saying it was benign and almost certainly a hemangioma.  MRI is the best imaging at differenciating a hemangioma from other lesions.  It's harder with small lesions but if you have MRI with Gadolinium contrast that should do it.  Just make sure to watch lesion by alternating ultrasound and MRI for a while. If it doesn't change that is what you look for.  Usually a hemangioma has been there all along and just now someone mentioned it, since small (mine was 11mm on ultrasound and 6mm on both CT and MRI).  They sometimes will grow, but most times do not.  They also are more common in females.  Good luck, I know how stressful it is when you find that out.

[StephenCastlecrag]

I am not a doctor, so I can only make some very general comments. You should consult your liver specialist regarding your CT scan and other test results. Your specialist should be able to better answer all the questions that you have raised here.

You have responded well to Entecavir, with viral load undetectable which is very good. However, your ALT (SGPT) is still mildly elevated, also your clot time and INR are both out of range.You should raise these results with your specialist as they may indicate significant fibrosis of the liver. So until these results are looked at by your doctor, you should NOT stop your Entecavir as it may lead to a flare that may worsen the state of your liver.

We don't know your history, so I suggest a Fibroscan will be very useful to see whether you have significant fibrosis or not.

Just my opinion.