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Gastroenterology (Expert Forum)
liver lesion questions
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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liver lesion questions
by mikehf63, Oct 23, 2004 12:00AM
Last week I went for an abdominal CT scan to check for kidney stones. The scan uncovered a “hyperdense lesion partially exophytic from the medial posterior segment of the right lobe” of my liver. Yesterday, I had an MRI with contrast. The radiologist’s report said that the contrast showed up in the lesion, indicating that it is likely not a cyst. He recommends a biopsy.
I am 41 years old, 6’2” and 230 pounds (probably 20 too many for my frame). I had my spleen removed due to trauma 23 years ago. I was previously diagnosed with a fatty liver, although my enzymes are now close to normal. No hepatitis, no cirrhosis. My general health is fine, and I thus far show no symptoms of liver problems. On average, I have 3-4 alcoholic drinks a week (usually beer).
My obvious concern is that this is cancerous. Could this be anything else besides a tumor (benign or malignant)? I am anxious to get the biopsy done, but I just read about hemangiomas. Would a hemangioma be obvious to the radiologist (assuming he/she is competent)? And if it is a hemangioma, could a biopsy be dangerous, in terms of causing bleeding?
I am 41 years old, 6’2” and 230 pounds (probably 20 too many for my frame). I had my spleen removed due to trauma 23 years ago. I was previously diagnosed with a fatty liver, although my enzymes are now close to normal. No hepatitis, no cirrhosis. My general health is fine, and I thus far show no symptoms of liver problems. On average, I have 3-4 alcoholic drinks a week (usually beer).
My obvious concern is that this is cancerous. Could this be anything else besides a tumor (benign or malignant)? I am anxious to get the biopsy done, but I just read about hemangiomas. Would a hemangioma be obvious to the radiologist (assuming he/she is competent)? And if it is a hemangioma, could a biopsy be dangerous, in terms of causing bleeding?
Doctor's Answer
by Kevin Pho, MD, Oct 25, 2004 12:00AM
, Oct 25, 2004 12:00AM
Possibilities would include liver tumors (either benign or malignant), cysts, an abscess, as well as hemangiomas. Typically a radiologist should be able to discern whether there are features suggestive of a hemangioma or not. The MRI is a pretty good test to evaluate for this.
If there continues to be confusion about the diagnosis, the liver biopsy would be the appropriate next step. Regarding the concern about the hemangioma, this should have been adequately evaluated by the MRI.
You may want to inquire about another GI opinion if there continues to be concern about the lesion.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
If there continues to be confusion about the diagnosis, the liver biopsy would be the appropriate next step. Regarding the concern about the hemangioma, this should have been adequately evaluated by the MRI.
You may want to inquire about another GI opinion if there continues to be concern about the lesion.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
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