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What Do My Lab Test Results Indicate?

Posted on Mon, 3 Oct 2016

Question: I originally 'spoke to' Dr. XXXXXXX Chail and have received the results of a CT scan on my liver which states there is a lesion but it's inconclusive to exactly what it is and now I have been recommended to have an MRI. Will an MRI let me know if it is malignant or benign? Also, if it is malignant, what other symptoms may I be experiencing? (This whole investigation started due to raised enzyme levels in my blood results which I have had for a few years)

Answered by Dr. Vivek Chail (2 hours later)

Brief Answer:
MRI scan is very siensitive for evaluating liver lesions

Detailed Answer:

Hi,
Thanks for writing in to us.

As you might be aware MRI is the latest method to investigate liver lesions. A contrast enhanced MRI can help to differentiate benign from malignant lesions. There are certain characteristics which can tell whether a lesion is benign or malignant. The sensitivity of MRI for liver lesions is better than other methods. Youcan send your CT scan report so that I can know the details.

It is important to know that there can be no obvious physical symptoms in small liver lesions. In case of big liver lesions, there can be abdominal pain, lump like feeling in abdomen, weakness, loss of weight and tiredness.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (43 minutes later)

Thank you Dr Chail - The CT Scan report is with my doctor and I am collecting it in a couple of days so may send it across to you then. I sometimes get a pain in my lower right abdomen, which is sometimes brought on after drinking or eating and sometimes it stays for a while and other times it is not there. I haven't been losing weight. My doctor has referred me to a gastroenterologist who I am seeing in 10 days (before MRI scan) Will the MRI scan include an iodine injection like the CT scan did? Thanks again (The original Ultrasound report stated the following - The liver has heterogeneous echotexture with mild increase in echogenicity generally suggestive of a fatty replacement. The left lobe of the liver appears bulky and somewhat irregular in outline and it is difficult to outline a discrete lesion. The left lobe of the liver has an abnormal expanded appearance and an isoechoic mass lesion is a possibility)

Answered by Dr. Vivek Chail (1 hour later)

Brief Answer:
An injection called gadoliniumBOPTA is given for liver MRI scans

Detailed Answer:
Hi,
Thanks for writing back with an update.

There is an injection called gadoliniumBOPTA which is given during detailed liver evaluation in MRI scan. This is a safe injection however a kidney function test is recommended before taking the injection. It has similar function like iodine contrast with reference to CT scan.

It is mentioned that your liver is having increased fat content with a suspicious lesion. The lesion is not clearly defined in ultrasound. In this situation the MRI scan can help.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (34 minutes later)

Thanks again Dr Chail - What are next steps if the MRI can't identify the lesion one way or another (or does it always?) - what happens next? Would it be a biopsy?

If it's benign, would I just live with it or is there a possibility it would be surgically removed?

If it's malignant, what are the options?

Thanks again, I think that's everything for now.

Answered by Dr. Vivek Chail (1 hour later)

Brief Answer:
A biopsy can help in many ways

Detailed Answer:
Hi,
Thanks for writing back with an update.

Reviewing your ultrasound report we find that there is no lesion identified and therefore CT scan was ordered. The CT scan reports are yet to arrive and there is a recommendation for MRI scan liver.

In the above situation, I would very much like to know what is visualized on CT scan and whether any lesion is really there.

If a lesion is identified on CT scan and MRI scan then probably a biopsy will be the investigation required.

If no lesion is identified then also a biopsy can be done.

Meanwhile a MR elastography can be discussed with your doctor and this test will tell the amount of stiffness and fibrosis in your liver.

Regarding options on finding a malignant lesion, it depends on the cell type and size. In small lesions a surgery is performed which is usually curative.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (18 minutes later)

Thank you - I may send you the CT report when I collect it next week.

Answered by Dr. Vivek Chail (18 hours later)

Brief Answer:
Please send your report when it is available

Detailed Answer:
Hi,
Thanks for writing back with an update.

Looking forward to read through your report when it is available.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (5 days later)

please find attached the report - can you please advise what this means?

Answered by Dr. Vivek Chail (4 hours later)

Brief Answer:
Likelihood of focal bodular hyperplasia which is a benign tumor

Detailed Answer:
Hi,
Thanks for writing back with an update.

The report show a probability of focal nodular hyperplasia in the left lobe of liver measuring 10 cm in diameter pending confirmation by MRI scan.

A focal nodular hyperplasia is a common benign tumor in the liver.

Other than the above, there might be a possibility of atypical hemangioma or hepatic adenoma is to be considered. These too are benign tumors.

MRI scan has a good confirmation rate of focal nodular hyperplasia.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar