liver biopsy results

[bournemouth]

Dear Dr. Thomas;
thank you for your time for helping people

could you please explain my liver biopsy results and explain more what they mean by small foci of pericellular fibrosis, is that can be treated????

my liver biopsy results as follow:

needle cores of hepatic tissue show marked steatosis (grade 3).
occasional mallory bodies are seen. there are small foci of pericellular fibrosis. no evidence of cirrhosis is seen.
the appearance are of a low grade steatohepatitis.
the differential diagnosis(if alcohol has been excluded) includes diabetes mellitus, obesity and drug reaction ? lansoprazole
discussion at an MDT might be helpful

please could anyone explain to me exactly what does the results mean and what do you suggest the treatments?
is fibrosis can be treated or not

patien history:
I am 25 years old, I have evaluated alt between 120-240
I have done ultrasound the result was as follow:
technically difficult scan due to patien body habitus.
the liver is normal in size and contour. the echogenicity of the liver increased consistent with fatty infiltration.
the posterior aspects of the liver are poorly visualised due to loss of through transmation. situated with the region of the gallbladder fossa are 2 echo poor areas the largest measures 9mm in diameter. appearances are likely to represent area of facal fatty sparing.
pancreas  normal, the spleen, gallbladder, biliary tree appear grossly normal

thank you for help

[bournemouth]

thank you for your reply,
I would just like to let you know that I am 25 yrs old, my weight is 85kg and my hieght 176cm,
please could you describe the best treatment for me to reduce ALT and AST, is it fine to take statin as I have high triglycerides aswell, also is it good to have vitamin E supplements !!

  my last blood result come as follow :
serum gamma glutamyl 325  iu/l ( 9-44 U)
ALT    210   (0-35U)
AST  65     (0-35U)    
Serum Albumin 51 ( 35-48)
bilirubin 8 (0-17)
AP 83 (30-100)

Lipid profile as follow:

serum cholesterol 7.6 mmol/l
serum triglycerides 4.9 mmol/l
serum HDL cholesterol 0.86 mmol/l
serum cholesterol/HDL ratio 8.8

Renal Profile : normal no action

Biopsy results:
needle cores of hepatic tissue show marked steatosis (grade 3).
occasional mallory bodies are seen. there are small foci of pericellular fibrosis. no evidence of cirrhosis is seen.
the appearance are of a low grade steatohepatitis.
the differential diagnosis(if alcohol has been excluded) includes diabetes mellitus, obesity and drug reaction ? lansoprazole

ultrasound Results:
the liver is normal in size and contour. the echogenicity of the liver increased consistent with fatty infiltration.
the posterior aspects of the liver are poorly visualised due to loss of through transmation. situated with the region of the gallbladder fossa are 2 echo poor areas the largest measures 9mm in diameter. appearances are likely to represent area of facal fatty sparing.
pancreas  normal, the spleen, gallbladder, biliary tree appear grossly normal

thank you for your help

[Thomas D Schiano, MD]

the report suggests that you have fatty liver.  I presume that you have a little bit of extra weight on board if the ultrasound was difficult to perform.  All of these changes are thus potentially reversible with weight loss. the very beginning of fibrosis is present.  the foci of piecemeal necrosis is part of the inflammatory process associated with steatohepatitis.