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What Do My PET Scan And CT Scan Test Reports Indicate?
Question: I just had PET scan and CT scan last week to determine if I have cancer in my stomach and organs most specifically on my liver. Based on the result of the tests and my oncologist review, it is not showing any cancerous formation. However, the results is showing "The liver has modular margins...right hepatic lobe demonstrates a heterogeneous parenchymal at segments 8 and 7.... prominent tortuous vessels are seen in segment 7.... ... there are two punctuate in segments 8 and 3...a well circumscribed subcentimeter nonenhancing focus at segment 8 suggestive of a cyst.
The Conclusion on my liver tests indicates: "No evidence of any hypermetabolic lesion on the liver or elsewhere in the body. Evidence of nodular liver margins suggestive of cirrhosis and heterogeneous praenchymal of the right hepatic lobe particularly in segments 8 and 7 may still be related to cirrhosis or secondary to an infiltrative lesion such as neoplasm."
This PET scan and CT scan tests were taken as recommended by my oncologist who referred me back to my Gastroentorologist. These tests were done due to very high alphafetoprotein results (recent test on Sept 9 was 48729, second tests Nov. 11 was 54000 ng/mL) TIBC result is 49.0 umol/l. Ferritin is 1996 ng/mL as well as other type of tests. My Gastroentorologist requires me to take a liver biopsy as soon as possible to determine what is causing the inconsistent results. She suspects that it may be advance form of cirrhosis but not yet maturely develop into cancer. In the mean time I am feeling a little bloated and at times a little pain in my stomach but she only prescribes eldecit to be taken whenever I feel bloated.
My questions are:
1) Based on the results of the PET/CT Scan as described above do you have any other opinion or concern. Any explanation of the results in lame term?
2) A biopsy of my liver would not be possible until two weeks from now. Will I continue to experience a more intense pain in my stomach as time goes by before the biopsy?
3) Is eldecit the proper medication for my discomfort based on the tests results and discomfort?
4) My Gastroentorologist, did not mentioned any restriction on any food intake. All she said is to reduce my iron intake. Is there anything else I should observed other than iron intake. Any medicine available that would help reduce the high iron?
5) Anything else I should know or any recommendation from you or for review of other specialist other than Gastroentorologist and oncologist?
Thanks!
XXXX
The Conclusion on my liver tests indicates: "No evidence of any hypermetabolic lesion on the liver or elsewhere in the body. Evidence of nodular liver margins suggestive of cirrhosis and heterogeneous praenchymal of the right hepatic lobe particularly in segments 8 and 7 may still be related to cirrhosis or secondary to an infiltrative lesion such as neoplasm."
This PET scan and CT scan tests were taken as recommended by my oncologist who referred me back to my Gastroentorologist. These tests were done due to very high alphafetoprotein results (recent test on Sept 9 was 48729, second tests Nov. 11 was 54000 ng/mL) TIBC result is 49.0 umol/l. Ferritin is 1996 ng/mL as well as other type of tests. My Gastroentorologist requires me to take a liver biopsy as soon as possible to determine what is causing the inconsistent results. She suspects that it may be advance form of cirrhosis but not yet maturely develop into cancer. In the mean time I am feeling a little bloated and at times a little pain in my stomach but she only prescribes eldecit to be taken whenever I feel bloated.
My questions are:
1) Based on the results of the PET/CT Scan as described above do you have any other opinion or concern. Any explanation of the results in lame term?
2) A biopsy of my liver would not be possible until two weeks from now. Will I continue to experience a more intense pain in my stomach as time goes by before the biopsy?
3) Is eldecit the proper medication for my discomfort based on the tests results and discomfort?
4) My Gastroentorologist, did not mentioned any restriction on any food intake. All she said is to reduce my iron intake. Is there anything else I should observed other than iron intake. Any medicine available that would help reduce the high iron?
5) Anything else I should know or any recommendation from you or for review of other specialist other than Gastroentorologist and oncologist?
Thanks!
XXXX
Brief Answer:
Liver biopsy is important to before deciding on treatment
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. I have done training in cancer radiology and would like to help you out understand the PET CT scan findings better. The report shows that the liver shows nodules, these refer to rounded patterns seen in the liver and this is a strong indicator of cirrhosis of the liver. The right lobe of the liver also shows a non regular pattern in the liver substance in segments 3 and 8. This can be either due to liver cirrhosis. Sometimes, such a pattern can predispose to a cancer in the liver over months to years, however in your case no cancer like feature in the area has been noted. Rarely a cancer can exist in this fashion, without the typical features of increased metabolism. Probably due to the high AFP levels, your doctors do not want to neglect this finding and have recommended a liver biopsy.
There are prominent blood vessels in the segment 7 and two punctate are not a specific finding. The cyst in segment 8 is not significant.
In conclusion, the liver biopsy is quite important and the final diagnosis and treatment will be based on it. The cause for the abnormal liver pattern has to be evaluated in detail.
2. Pain in the stomach region is probably due to the mechanical stretching or irritation of pain sensitive nerve fibers around the various organs including the liver. It is not possible to exactly predict the pain characteristics before the biopsy which is to happen in two weeks. However there is no definite reason in the scan due to which the pain should increase in such a short interval.
3. Eldicet is pinaverium and is useful in reducing spasmodic pain in the abdomen. It should work for your pain and is recommended.
4. Nutrition has to be maintained and that is the reason you should take food recommended for your age and weight. There is no particular food restriction. However if you have alcohol regularly then please control that. Iron has to be decreased and that is suggested by your doctor.
Serum ferritin can be raised due to alcohol consumption, metabolic syndrome, obesity, diabetes, liver disease, malignancy, infection or inflammation. Without doing a liver biopsy, any treatment for increased ferritin is not advisable.
5. The gastroenteroligist and oncologist are the right specialists to consult and I believe they are working together to investigate the cause for your PET CT findings. The biopsy will be reported by a pathologist and if required they will discuss with a hematologist. As such you need not particularly reach out to any other specialist doctor other than the gastroenterologist and oncologist.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Liver biopsy is important to before deciding on treatment
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. I have done training in cancer radiology and would like to help you out understand the PET CT scan findings better. The report shows that the liver shows nodules, these refer to rounded patterns seen in the liver and this is a strong indicator of cirrhosis of the liver. The right lobe of the liver also shows a non regular pattern in the liver substance in segments 3 and 8. This can be either due to liver cirrhosis. Sometimes, such a pattern can predispose to a cancer in the liver over months to years, however in your case no cancer like feature in the area has been noted. Rarely a cancer can exist in this fashion, without the typical features of increased metabolism. Probably due to the high AFP levels, your doctors do not want to neglect this finding and have recommended a liver biopsy.
There are prominent blood vessels in the segment 7 and two punctate are not a specific finding. The cyst in segment 8 is not significant.
In conclusion, the liver biopsy is quite important and the final diagnosis and treatment will be based on it. The cause for the abnormal liver pattern has to be evaluated in detail.
2. Pain in the stomach region is probably due to the mechanical stretching or irritation of pain sensitive nerve fibers around the various organs including the liver. It is not possible to exactly predict the pain characteristics before the biopsy which is to happen in two weeks. However there is no definite reason in the scan due to which the pain should increase in such a short interval.
3. Eldicet is pinaverium and is useful in reducing spasmodic pain in the abdomen. It should work for your pain and is recommended.
4. Nutrition has to be maintained and that is the reason you should take food recommended for your age and weight. There is no particular food restriction. However if you have alcohol regularly then please control that. Iron has to be decreased and that is suggested by your doctor.
Serum ferritin can be raised due to alcohol consumption, metabolic syndrome, obesity, diabetes, liver disease, malignancy, infection or inflammation. Without doing a liver biopsy, any treatment for increased ferritin is not advisable.
5. The gastroenteroligist and oncologist are the right specialists to consult and I believe they are working together to investigate the cause for your PET CT findings. The biopsy will be reported by a pathologist and if required they will discuss with a hematologist. As such you need not particularly reach out to any other specialist doctor other than the gastroenterologist and oncologist.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr, XXXXXXX Now I am understanding more the problems I am encountering. I will be going back to the phillipines for the biopsy within the next two weeks. Just one information I failed to include is that I am a type 2 diabetic for the past 10 years. The diabetic was a result of pancreatic injury directly related to alcohol. Other than that through my recent Executive checkup at Asian Hospital in the Phillipines there's no significant findings except the enlargement of my colon and very tiny pulps when they did the visual colonoscopy.
My other Dr. has prescribed Legalon after the Executive checkup. He never explained what this medicine for. Can you explain?
Thanks! XXXXXXX
My other Dr. has prescribed Legalon after the Executive checkup. He never explained what this medicine for. Can you explain?
Thanks! XXXXXXX
Brief Answer:
Legalon is to protect your liver
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. There are probably multiple factors causing high ferritin and your liver changes. It is true that alcohol consumption and diabetes for 10 years can cause this condition.
2. The medicine legalon contains silymarin and this is used in the treatment of chronic liver conditions. Your doctor has give this to protect your liver.
3. The polys need to be reviewed regularly as recommended by the gastroenterologist. Let us hope for the best regarding your liver biopsy report.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Legalon is to protect your liver
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. There are probably multiple factors causing high ferritin and your liver changes. It is true that alcohol consumption and diabetes for 10 years can cause this condition.
2. The medicine legalon contains silymarin and this is used in the treatment of chronic liver conditions. Your doctor has give this to protect your liver.
3. The polys need to be reviewed regularly as recommended by the gastroenterologist. Let us hope for the best regarding your liver biopsy report.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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