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    What does my ultrasound scan report indicate?

Posted on Thu, 7 Sep 2017 in Abdominal Pain
Question: I had my yearly physical checkup in May, 2017. Full blood work and urinalysis came back normal except for a low eGFR. I had a follow up stomach ultrasound 3 weeks ago to monitor gallbladder poly. HOWEVER, ADDITIONAL FINDINGS ON LIVER on my full abdominal u/s: PLEASE EXPLAIN WHAT THIS REPORT MEANS! Dr did not explain, said not a big deal...Why am I having these growths? Vitamin supplements/diet? Is it cancer or liver disease?
"3 hyperechoic foci are identified within the liver. One was in segment 6 measuring 2.5x1.4x2.1 cm (last year 2x1x1.8 cm), stable in size, however its sonographic characteristics have changed, as it is diffusely hyperechoic today, demonstrating hypoechogenicity previously.
Two new lesions are identified, one within segment 7 measuring 1.4x1.5x1.4 cm and one within segment 4A measuring 7x5x4 mm.

Stable gallbladder polyp measuring 5 mm. Pancreatic tail not well-visualized, however the remainder is normal. Spleen and left kidney normal. Right kidney demonstrates a 5mm cortial cyst.

Impression:Dominant hyperechoic lesion within the liver is overall stable in size however its sonographic characteristics have changes, as described.
Two new hepatic lesions identified.
Given the aforementioned findings, multiphasic MR of liver recommended for further characterization."
Answered by Dr. Bhagyesh V. Patel 43 minutes later
Brief Answer:
Different possibilities for etiology.provide more details please .

Detailed Answer:
Hello dear

Thanks for using Healthcaremagic.com
I have evaluated your query thoroughly .

* There are various conditions giving hyperechoic lesions in the liver which may
be benign ( hemangioma or other ) or malignant ( metastasis or
hepatocellular carcinoma or other ) .

Kindly provide further details so that I can answer your query completely .

1. Any symptoms at present which you are having .
2. Any alterations in weight , appetite .
3. There has been mentioned changes in sonographic characteristics , is previous
USG available to compare the same .
4. Are you having hypercholesterolemia , diabetes or other systemic disorder .
5. Alcohol intake , smoking if any .

Awaiting for your response .

Regards .
Above answer was peer-reviewed by : Dr. Vaishalee Punj
Follow up: Dr. Bhagyesh V. Patel 10 hours later
1. the odd upper right abdominal pain (about a month ago severe pain 20 seconds, but nothing like that since then)
2. appetite same..trying to lose 10 pounds, exercise daily PB 130/85
4. Bloodwork in May 2017 was all within normal limits, except High Vitamin B12.
5. I do not smoke or drink

3. Previous ultrasound reports:
Aug 2013 "No abnormalities seen in pancreas/spleen/kidneys/abdominal aorta. Liver is of uniform echogenicity and bile ducts are not dilated. Gallbladder has normal thickness, free of calculi"

Aug 2015 - Right lobe of liver 2.1x1.5x1.9 cm well defined slightly hyperechoic mass consistent with hemangioma. No other liver lesions seen. Mild irregularity of gallbladder wall at fundus with questionable 6mm polyp. All other organs normal. Liver lesion seen on recent CT has appearance of hemangioma.

Feb 2016 - Slightly echogenic mass in right lobe of liver 2.0x1.8x1.7 cm and is stable from August 2015. Incidental adenomyomatosis is suspected in fundus of gallbladder. All other organs normal.

July 2016 - Liver demonstrates hyperechoic nodule with more echogenic periphery in lateral aspect of right lobe measuring 2.1x1.4x2.0 cm, previously 2.0x1.8x1.7 cm and 2.1x1.5.1.9 cm. Gallbladder demonstrates 5mm probable fundal polyp. No bilary tree dilation. Pancreas, spleen, kidneys, abdominal aorta within normal limits. No significant free fluid. Opinion: Hepatic nodule not significantly changed since previous examinations. Long term stability should be demonstrated. 5 mm gallbladder polyp.

I have been taking Vitamin B and 2000mg of Vitamin C/Lysine supplements over the past few years. Could this cause liver issues?
Answered by Dr. Bhagyesh V. Patel 2 hours later
Brief Answer:
follow up narrations provided thoroughly .

Detailed Answer:

* Change in the echogenicity of liver lesions as hemangioma are common from
hypoechogenicity to hyperechogenicity with times .

* As per the detailed case study of your all reports , medicines consumed
my conclusions

- Lysine intake is known for increase in cholesterol levels .
- Lysine consumption is not recommended beyond some time limits without
medical guidance and supervision .

- Vitamin B & C are not at fault .

- Many dietary items also contain Lysine so ultimately your body gets more
levels than desired , might be responsible for liver damage .

- Must avoid all oily , spicy , non veg stuffs as beef , cheese, turkey , chicken ,
shrimp , shellfish , eggs , beans , lentils , dairy fat till possible .
- Regular walking , exercises , YOGA are beneficial on long term basis .
- Strictly maintain your body weight , blood sugar , cholesterol levels .

- Gall bladder polyp is of not much botheration at present .
- Keep regular watch on the size , progress of the lesions with sequential USG

Hope this helps you .
Welcome for further guidance .

Regards .
Above answer was peer-reviewed by : Dr. Yogesh D
Answered by
Dr. Bhagyesh V. Patel

General Surgeon

Practicing since :1999

Answered : 15831 Questions


The User accepted the expert's answer

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