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ALT liver function elevated, mild fat infiltration. Referred to gastro and biopsy. Lymphoma or cancer?

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Gastroenterologist
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I am a 24 year old male. I am 5 11 and 196lbs (at the time of blood tests in Sept.).
In September I went to the Dr to get some blood drawn for a physical and all of my results were in normal range with the exception of my ALT liver funtion, which was elevated to 143. I then was referred to a Gastro, who had me do an ultrasound of my liver and everything was normal with the exception of mild fat infiltration. Then had a CT scan that was normal but it showed same with fat infiltration. I have been tested for Hep which was negative, and all other blood tests are normal. (all LFT and literally 50 more or so other tests for Wilsons etc normal). I have totally changed up my lifestyle eating better, exercising more, I weigh 180 now (lost 16lbs!). I am due for a liver biopsy in two weeks. Could this be something like lymphoma or liver cancer, even though the scans were clean? And would something like lymphoma turn up in a biopsy of my liver even though there is no specific part of my liver to biopsy? I am mostly afraid of cancer please let me know if it is a possibility?

Below are my ALT levels over the course of Sept-Nov.
9/12/2011 143
9/14/2011 157
9/19/2011 141
9/26/2011 77
10/1/2011 69
10/21/2011 58
11/18/2011 82
Posted Tue, 17 Apr 2012 in Liver and Gall Bladder
 
 
Answered by Dr. Poorna Chandra K.S 4 hours later
Hi and thanks for the query.

By the description, I understand that you are overweight, have an elvated ALT and a fatty liver.

This is classical of a condition called Non alcoholic steatohepatitis (NASH) provided you do not take alcohol and other causes are ruled out.

Hypertension, impaired glucose test or diabeties and lipid abnormalities are the frequent accompaniments. Sometimes some of the antidepressants cause XXXXXXX

Liver biopsy not only confirm a diagnosis of XXXXXXX but also helps to stage the liver injury.

With a normal CT the probability of presence of a tumor is very unlikely and primary lymphoma of liver is very rare and is usually associated with an enlarged spleen. Hence go ahead with liver biopsy without any undue fear and continue with the better lifestyle that you have adopted.

Aim for a gradual weight loss as a rapid weight loss worsens liver inflammation.

Hope, this answers your query. Please accept my answer in case you do not have follow up queries.

Regards.
Dr XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: ALT liver function elevated, mild fat infiltration. Referred to gastro and biopsy. Lymphoma or cancer? 1 hour later
Can simple fatty liver cause these elevations in ALT or is is most likely XXXXXXX

I am only 24 does that play a role in this?
 
 
Answered by Dr. Poorna Chandra K.S 10 hours later
Hi and thanks for the fresh query.

Simple fatty liver has normal liver function test reports and SGPT/ALT elevation occurs in XXXXXXX

Age has no bearing and it is the obesity and other associated diseases listed earlier that are important.

Insulin resistance is the basic pathogenic mechanism of fatty liver.

Hope, this answers your query. Please accept my answer in case you have no follow up queries.

Regards.
Dr XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: ALT liver function elevated, mild fat infiltration. Referred to gastro and biopsy. Lymphoma or cancer? 38 minutes later
Can XXXXXXX be reversed?
 
 
Answered by Dr. Poorna Chandra K.S 1 hour later
Hi
Reversal of XXXXXXX depends on the stage of the disease which can be determined via liver biopsy. However adopting a active life style not only improves the liver histology and functions but also reduces the risk of strokes and heart attack
Hope, this answers your query
Regards
Dr XXXXXXX
Above answer was peer-reviewed by
 
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