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Suggest Treatment For Lesion On Liver Nodule
Question: I am 77 year old Male non smoker. Diabetic type 1 under controll with Amaryl Having Blood pressure under control with Lipril 5 mg Thyroid imbalance under contro with 100 mg Thyroxin since more than 15 Yrs
I was taking Alcohal frequently around 60 ml. On loss of appetite Color Dopler Scan taken Liver 26-02-2014: Parenchymal echotexure increased , hypoehoic nodule Rt lobe 19.6x 16.3 mm hard in ELESTOGRAPHY .Rest of Parenchyma normal stiffness with ARFI values between 0.88-1.66mt/ .No IHBD. CBD normal Fatty infiltration of liver
CT Scan 18-04-214 : Liver Hypodence lesion in segment 8 Rt lobe.
PET-CT Whole body : Ill defined hyper metabolic lesion involving segment VIII of Liver
MRI :Liver Nodular lesion 2.4 x 2.2 cms in segment 7
Biopsy : Positive for malignancy Carcinoma Highgrade Hepato cellular Carcinoma Cholngio carcinoma
Operated 11-05-2014 : Bisegmntectomy ( Segment 5&8 of liver) done Nko periportal nodes,Liver I am 77 years undergone Hepato cellular carcinoma surgery lobotomy is udone 7 months back and doctors said no I need of any treatment as it is primary and surgically removed My liver function test show normal
Color Doppler scan 08-11-2014 : Rt .lobe smaller Lt. lobe increase in size with Irregular Contours and Parenchymal echotexure is altered No focus lesion No Ascites
LFT 30-12-2014 : GGTP ( gamma-GT ) 121 Globulin 3.7 All other are with in the normal range
1 . Does the irregular cantours mean Cirrohsis of Liver ,if so is it progressing ,if so how much time it will take for the Liver to become non functional
2 Is it all due to Alcohal I totally stopped Alcohal since surgery.
3. If I take Alcohal 30 - 60 ml once in a week or so does the Cirrohsis if it is runs into total scarring of liver or does it accelerates the prognosis if so how much time it will take takes years by the time liver become totally Cirrohsis. Irregular Cantours are the warning for onset of Cirrohsis to totally destroy the liver
4 I learn Cirrohsis cannot be reversed but progress can be stopped tand it or pace can be reduced I am given to undersCan you enlighten
What is the condition of my liver and
I was taking Alcohal frequently around 60 ml. On loss of appetite Color Dopler Scan taken Liver 26-02-2014: Parenchymal echotexure increased , hypoehoic nodule Rt lobe 19.6x 16.3 mm hard in ELESTOGRAPHY .Rest of Parenchyma normal stiffness with ARFI values between 0.88-1.66mt/ .No IHBD. CBD normal Fatty infiltration of liver
CT Scan 18-04-214 : Liver Hypodence lesion in segment 8 Rt lobe.
PET-CT Whole body : Ill defined hyper metabolic lesion involving segment VIII of Liver
MRI :Liver Nodular lesion 2.4 x 2.2 cms in segment 7
Biopsy : Positive for malignancy Carcinoma Highgrade Hepato cellular Carcinoma Cholngio carcinoma
Operated 11-05-2014 : Bisegmntectomy ( Segment 5&8 of liver) done Nko periportal nodes,Liver I am 77 years undergone Hepato cellular carcinoma surgery lobotomy is udone 7 months back and doctors said no I need of any treatment as it is primary and surgically removed My liver function test show normal
Color Doppler scan 08-11-2014 : Rt .lobe smaller Lt. lobe increase in size with Irregular Contours and Parenchymal echotexure is altered No focus lesion No Ascites
LFT 30-12-2014 : GGTP ( gamma-GT ) 121 Globulin 3.7 All other are with in the normal range
1 . Does the irregular cantours mean Cirrohsis of Liver ,if so is it progressing ,if so how much time it will take for the Liver to become non functional
2 Is it all due to Alcohal I totally stopped Alcohal since surgery.
3. If I take Alcohal 30 - 60 ml once in a week or so does the Cirrohsis if it is runs into total scarring of liver or does it accelerates the prognosis if so how much time it will take takes years by the time liver become totally Cirrohsis. Irregular Cantours are the warning for onset of Cirrohsis to totally destroy the liver
4 I learn Cirrohsis cannot be reversed but progress can be stopped tand it or pace can be reduced I am given to undersCan you enlighten
What is the condition of my liver and
Brief Answer:
Hello, Need to stop alcohol.
Detailed Answer:
Hi,
Welcome to HCM.
I understand your concern.
1) l likely you have cirrhosis of liver as suggested by irregular contour on ultrasonography.
But the most important test to confirm that is the liver resection specimen around the tumor is likely to show cirrhotic changes.
Also presence of esophageal varices on endoscopy if done earlier nearly confirms the diagnosis.
Cirrhosis is known to progress with time especially if the ongoing insult is continued. It may take variable time for it to progress and it depends on many things like continued liver damage with insults like alcohol, hepatitis B, C (untreated). Also additional insults like infections, kidney problems, some drugs may worsen liver problem and may cause liver to fail early.
2) good you are off alcohol. Also liver functions may reduce with age and alcohol intake, some times despite stopping alcohol it may worsen with time.
3) Need to stop alcohol completely asyou have an underlying possibly cirrhotic liver with resection leading in loss of liver volume.
4) Well on stopping of offending agents like alcohol the liver functions stabilize and may improve with time partially. your present liver conditions needs to be addressed very carefully to avoid future problems.
Best wishes.
Happy to help.
Wish you a speedy recovery.
Hello, Need to stop alcohol.
Detailed Answer:
Hi,
Welcome to HCM.
I understand your concern.
1) l likely you have cirrhosis of liver as suggested by irregular contour on ultrasonography.
But the most important test to confirm that is the liver resection specimen around the tumor is likely to show cirrhotic changes.
Also presence of esophageal varices on endoscopy if done earlier nearly confirms the diagnosis.
Cirrhosis is known to progress with time especially if the ongoing insult is continued. It may take variable time for it to progress and it depends on many things like continued liver damage with insults like alcohol, hepatitis B, C (untreated). Also additional insults like infections, kidney problems, some drugs may worsen liver problem and may cause liver to fail early.
2) good you are off alcohol. Also liver functions may reduce with age and alcohol intake, some times despite stopping alcohol it may worsen with time.
3) Need to stop alcohol completely asyou have an underlying possibly cirrhotic liver with resection leading in loss of liver volume.
4) Well on stopping of offending agents like alcohol the liver functions stabilize and may improve with time partially. your present liver conditions needs to be addressed very carefully to avoid future problems.
Best wishes.
Happy to help.
Wish you a speedy recovery.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Surgical Histopathology : Fibrosis ; Moderate - Ishak Score -IV Pathological changes; mild to moderatefattychanges seen in parenchyma What does the result indicate Does it confirm cirrhosis
Liver resection ; is it to be done along with endoscopy
What is the conclusive test if any to be done
What is difference between Cirrohtic and cirrohsis
You advice further tests to confirm cirrohsis is set in the liver and is progressing Any drug to stop further deterioration
Liver resection ; is it to be done along with endoscopy
What is the conclusive test if any to be done
What is difference between Cirrohtic and cirrohsis
You advice further tests to confirm cirrohsis is set in the liver and is progressing Any drug to stop further deterioration
Brief Answer:
Hello, sorry for delay in answering
Detailed Answer:
Hi
Well the reports of histopathology does not match with the score that you have mentioned.
Please upload the reports of resection specimen histopathology for correct interpretation of Same.
Best test is histopathology only.
No other test needed to confirm.
No definite drug to prevent cirrhosis progression, only offending agents need to addressed which includes stopping of alcohol.
Also cirrhotic and cirrhosis are same terminologies.
Best wishes.
Hello, sorry for delay in answering
Detailed Answer:
Hi
Well the reports of histopathology does not match with the score that you have mentioned.
Please upload the reports of resection specimen histopathology for correct interpretation of Same.
Best test is histopathology only.
No other test needed to confirm.
No definite drug to prevent cirrhosis progression, only offending agents need to addressed which includes stopping of alcohol.
Also cirrhotic and cirrhosis are same terminologies.
Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I uploaded the Report please examine and give your opinion at what stage is Cirrohsis and how much time it will take to totally destroy the liver
Brief Answer:
HI
Detailed Answer:
Thank you for the reports. You have significant fibrosis in liver. It may progress to XXXXXXX cirrhosis with time. Hence it is very important to prevent further damage by prevention additional insult to liver like stopping alcohol, controlling weight if obese, control diabetes if any and avoiding liver toxic drugs.
The progression of liver disease will depend on these factors. No specific time duration can be predicted.
Best wishes
HI
Detailed Answer:
Thank you for the reports. You have significant fibrosis in liver. It may progress to XXXXXXX cirrhosis with time. Hence it is very important to prevent further damage by prevention additional insult to liver like stopping alcohol, controlling weight if obese, control diabetes if any and avoiding liver toxic drugs.
The progression of liver disease will depend on these factors. No specific time duration can be predicted.
Best wishes
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Hello
Detailed Answer:
Thank you for the query.
there is currently no medication proven to revert fibrosis.
In presence of significant fibrosis any amount of alcohol is best to be avoided it can fasten the rate of progression to fibrosis.
It really difficult to predict how much time it will take to convert to cirrhosis with social drinking.
Thank you.
Regards.
Hello
Detailed Answer:
Thank you for the query.
there is currently no medication proven to revert fibrosis.
In presence of significant fibrosis any amount of alcohol is best to be avoided it can fasten the rate of progression to fibrosis.
It really difficult to predict how much time it will take to convert to cirrhosis with social drinking.
Thank you.
Regards.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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