Discovery of a liver nodule

General Discussion
21

Hi

I understand you are concerned about this lesion found on your ultrasound. Hopefully the MRI you receive will clarify what it is. Last year a pancreatic lesion was found on my US. I later found out that people with HBV have 2X higher rate of pancreatic cancer than the general population. Thankfully the MRI with contrast showed it was most likely a lipoma. Try to take deep breaths and be calm waiting for the MRI. Unfortunately I was so anxious during my MRI that I had a panic attack and was unable to follow the techā€™s instructions of holding my breath. Iā€™m grateful he was a friend of mine and he was patient with my hyperventilating but he did say it was the most difficult MRI he had to do and he has years of experience! Wishing you all the best news.

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22

Hoping for the best results for you. Try not to stress too much. Try not to think about until the test results come in.

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23

Hi @Bhakkd,

Welcome to the forum and thanks for sharing your story. It can be so tough getting all of this information about yourself! Haemangiomas are actually quite common in the whole community (~20% of people will have them and have no symptoms whatsoever - Liver hemangioma - Symptoms & causes - Mayo Clinic). Itā€™s just that since we have Hep B and get monitored, we find out (and worry!) about them. Really hope everything goes OK with the MRI and it really is nothing to worry about (indeed, most of these liver masses are benign).

Hope this helps a bit.

Thomas

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24

Thank you all of you for sharing your experiences and knowledge. I feel a lot better.

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25

Hay Thomas its been a while I hope your doing well :pray: As for me Iā€™ve been working a taking care my self best I can. Doing my routine check upā€™s a such. I had my routine check a couple days ago my blood work an ultrasound. My blood work shows really low levels of hep b also all other work blood work doesnā€™t show any cancer going on. When they did the ultrasound sound on me they saw a a few cyst from the past that are benign from my previous ultrasounds. They found a new 3 cm solid lesion on the same lobe as my cyst are on. there not to sure if itā€™s benign a want to do a CT scan. I wanted to know whatā€™s your input on this matter a strategies they use in these cases. I also would love if any other professionals on here you know that would have good input on this too. @john.tavis @availlant

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Dear @Eddie,

Unfortunately, this is well beyond my area of expertise as Iā€™m a molecular virologist, nor a physician or hepatologist. My only comment would be that as your physician feels a CT scan is warranted, then I would recommend getting one.

I wish you the very best.

John.

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I totally understand. Thank you for the reply, though John.:pray:

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Hi @Eddie,

Great to hear from you again, though sorry it is under such worrying circumstances. Indeed, my suggestions are going to be much the same as Johnā€™s above. And keep in mind that benign conditions are more common than malignant ones.

Hope this helps,
Thomas

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29

Hi guys,

New member here. I am so grateful to have found such a wonderful community and appreciate all the contributors here, whether the experts or fellow patients.

I donā€™t know where to start a new topic so I will seek opinions here. Long winded post, sorry :slight_smile:

Background:

Iā€™m 40y Chinese male from Malaysia. I was diagnosed CHB (HbeAg-) in 2014 at age 30. Later found out my mother is & my late grandmother was CHB so most likely thatā€™s the cause of infection. Grandmother died from stroke at age 80+ but her brother (who was also CHB) died from HCC at age 40+.

I have been monitored regularly since 2022 in a public hepatology center. Occasionally get ultrasound screenings from my family doctor (who urged me to get monitored) if the appointments with hepato are over 6 months. I have not started any treatment.

Some quick stats:

HBV DNA:
18 Oct 2021 - 4632 IU/mL (first-ever HBV DNA test)
11 Oct 2023 - 739 IU/mL

Fibroscan:
11 Oct 2023: 5.3 kPa / 0.6 / CAP score 211 (no fibrosis, no steatosis)

ALT:
Always hovers around 14-20, latest result (14 Mar 2024) - 25.2 U/L (slightly higher)

AFP:
Always @ 2.0 or below, latest result (14 Mar 2024) - 2.0 ng/ml

Imaging tests (a few ultrasounds & a 4 phase contrasted CT):
Multiple lesions were found. Details follow.

24 Apr 2022 - First ultrasound with family doctor. Found a lesion measuring 1cm x 0.8cm at segment IV. He said hemangioma.

27 Jan 2023 - Second ultrasound with him found another lesion measuring 0.7cm x 0.6cm at segment VII. Again, he said hemangioma.

11 Oct 2023 - Ultrasound at hepato. Findings as below:
The liver has normal echogenicity with smooth margins. Liver span measures 12.6cm in right midclavicular line. Multiple subcentimeter hyperechoic lesions seen at segment II, IV and VII. Largest at segment VI measuring 0.9 x 0.9 cm (I guessed she had a typo here - should be segment IV?). No intralesional vascularity.
Impression: Multiple hyperechoic lesions may represent regenerative nodules. Suggest AFP correlation, KIV contrasted CT scan if AFP high.

14 Mar 2024 - CT scans at hepato despite low AFP @ 2.0. Findings as below:
Liver is homogenous and has smooth outline. There are several ill defined non enhancing hypodense liver lesions scattered in both liver lobes, at segment II, IVa, V, VI and VI. Largest at segment IVa measuring 0.8cm in diameter. No focal enhancing liver lesion.
Impression: Non enhancing liver lesions in both liver lobes may represent regenerative nodules.

So my questions are:

  1. Hepatologist told me regenerative nodules happen when you have fibrosis/cirrhosis which I have none according to my Fibroscan. He was kind of disagree with radiologist to characterize the lesions as regen nodules but he has no conclusion of what they are. But he does not seem too concerned either. What can the lesions potentially be or can a non-cirrhotic liver have regenerative nodules from past damage?

  2. Are the so-called regenerative nodules potentially cancerous?

  3. How can a HCC history of an extended family member (in this case my granduncle) affect my own risk or only first-degree relatives matter?

  4. Does the fluctuation of HBV DNA mean anything when someone is in inactive carrier phase without the evidence of fibrosis &or elevated ALT? Is it kind of normal when not treated?

Thank you so much for your time to read through.

Regards
Steve

30

Dear @functionalcure,

Thanks for sharing your story and welcome to the forum. Iā€™ll try my best to answer your questions given my expertise and the available data.

It is difficult to know what else these lesions could be, and this can really only be worked out with further investigations by your treating physicians.

As you say, regenerative nodules come about in cirrhosis. It is when the blood flow to liver cells is impeded and you get continual cell death and regeneration of sections of the liver. They are not cancerous in themselves, but are associated with liver cancer.

All the studies that Iā€™ve found have only looked at the effect of first-degree relatives, so itā€™s unknown to what extent the history of extended family members matters in HCC risk.

As far as I can tell from the literature, fluctuations in HBV DNA during this phase are reported, but not much is known about the clinical implications of them.

Hope this helps,
Thomas

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31

Hi everyone,

I just got my MRI report today. Good news is that the MRI confirmed that the lesion is a benign hemangioma. The MRI also indicated that I have mild gallbladder sludge. I am waiting for my doctor to review and talk to me about it.

Meanwhile, I wanted to thank this community for all the help and support while I was waiting for my MRI. Thanks a lot.

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32

I followed your post and prayed that God would be with you. I know how important this issue is to us with hepb. happy that the result brought a relieving diagnosis. Donā€™t be careless and follow up with your doctor. :pray:

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Thank you Thomas for taking the time to reply to me.

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Hi @Bhakkd,
That is such a great news. Very thankful and happy it all went well. We appreciate you letting us know. I bet it is a relief not having this hanging around your neck. Thanks, bansah1.

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Fantastic news, @Bhakkd! Thanks for keeping us up to date!

Thomas

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36

Thanx for the support Thomas an John. It ended up being benign. But man I was stressed. But over all I hope everyone is doing well.

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Fantastic news, @Eddie! Iā€™m really glad, it must be such a relief!

TT

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