EXPLAINER: Lab results and their interpretation

Hi Everyone,
Many things keep on coming up.
Instead, I have done Tripple phase CECT and scheduled for biopsy tomorrow at9AM.
The CT scan ruled out HCC. The findings are: a typical well defined lesion of 5.4× 5.6cm on the 7th segment of the right hepatic lobe. A biopsy is suggested for further evaluation.
Interesting is that sometime I experience some pain on the said location.I have also lost some 2kgs since then.
Although I am expectant on the outcome of biopsy, I am speculative on what it might be and the possible treatment.
Kinoti.

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That’s great Kinoti that they ruled out HCC! Appreciate the update

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Hello everybody!
I just got my results back from my routine check and I would appreciate your thoughts.

Some background: The past 2 years my viral load was dropping (without treatment). Specifically, in September 2020 it peaked at 3000 IU/mL. After that it started dropping hitting an all time low at 218 IU/mL 6 months ago. At the same time my alt levels gradually rose beyond the limit peaking at 79 U/L (limit 46 U/L) before falling back to normal levels six monts ago at around 20 U/L.

That brings us to today. My viral load rose to 786 IU/mL and my alt rose again 56 U/L (46
U/L being the upper limit). I have to say that due to the fact that I gained a few kilos the past months even before the results came out my doctor predicted/ warned me that my alt levels might be a bit elevated and told me not to worry should that happen. I also have to mention that I did a liver ultrasound which was completely normal.

I am sending my doctor the results now and I’m excpecting a call from him but I would appreciate any thought from the many @ScienceExperts in the forum.

Best regards,
Drew

Very glad to hear this. I read all your posts and everyday checking for any update from ur tests. Its very normla i think to lose weight when you are in a stressing situation. Hope with all my heart everything results the best way. :hugs:

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Thanks alot for your continued empathy and support.
This community is honestly a wonderful place to pour our hearts when we are down.
I have attached my latest CT scan results for perusal and any necessary inputs.
Kinoti.

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Hi @Kinoti ,

We use inches mostly in the U.S. so I did a conversion and that’s over 2 inches by 2 inches. That’s like the size of a little child’s hand. I don’t want to be morose, but that seems quite large. I think you said that your other results like blood labs were normal? I can’t remember if you were diagnosed with fibrosis or not but there’s got to be an explanation for that size of a lesion. There was no physical injury correct? I would be interested to see what the @healthexperts would offer about this result. The results of the biopsy will be interesting also.

I am glad if it’s not HCC but I would like to know what caused that size lesion. I also would ask the experts to explain what exactly a lesion is. I had thought that it was a cut or crevice but when I had both my colonoscopy and esophageal varices surgery, the paperwork and the doctors seemed like they would interchange the term, lesions with cysts and polyps a lot. This confused me because I thought lesions were more like a cut or indentation and cysts and polyps were growths that came outward. Who knows, maybe I mistook their meaning and there were all of them.

Hope your biopsy goes well and the results shed better light,

-Paul

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Fantastic it isn’t HCC. You may have lost weight from the stress.
Look up and take courage. I can imagine it’s very hard.

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Hi caraline,
I salute you. Thanks for carrying me here.
Kinoti

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Dear @Kinoti,

I’m very glad about your results if they have ruled out HCC. I hope you are feeling better and have the strength to keep going.

Regarding possibilities of what it could be, there are many benign things that it could be, such as haemangioma, cysts, or Focal nodular hyperplasia. If they are benign, and they are not causing you any trouble otherwise, then there might be no further treatment required.

Dear @drew_rous,

Great to hear from you again. Yes, ALTs and viral load can go up and down in waves for a while. Continual monitoring will let you and your doctor know if this becomes a problem (e.g. if fibrosis starts to occur) and you need interventions such as medication.

Hope this helps,
Thomas

Hi good people,
Today I went to this hospital for biopsy. Doctors were parturbed with how big my lesion is despite having not been there one year ago. I was amazed when they surrendered that they were unable to reach the location of the lesion It’s Soo deep inside they argued. Now I have to go to another bigger hospital maybe.
I also noticed they couldn’t comprehend fully the"arterial, the portal and the delayed phases" of CT scan in detecting HCC. My Radiologist told me with the results I posted, “it does’nt look like a HCC tumour, but I don’t know what it is. We have to do a biopsy to determine what it is”
Kinoti.

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Hi every
I will never forget to say thank you for always being there to encourage me. @Thomas,no words will ever be enough to thank you for your time and experts opinion.
My pain is very little and sporadic. Infact I am not sure if it is real pain or pain in the mind. I live a normal life, do and eat anything provided it’s healthy. This week, I expect to do some manourvers to work on biopsy… To know specifically what the lesion is.
Kinoti

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Thank you for the words and your time Availlant

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Hello @Kinoti,
I really hope you get some good news soon!

Dear @ThomasTu,
Happy to be hear again. Hope you are well!
According to my doctor as long as the viral load stays below 2000-3000, he is not even considering any treatment. From what you said, I understand that this flactuation can cause problems? How does HbAg factor in the bigger image?

Also, what does this viral load says in terms of transmission danger? Is it really low?

Best,
Drew

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I think it becomes a problem if ALTs are persistently high. In this case, it is worth considering treatment to limit any liver disease.

Thomas

Hi @Thomas
Thanks for being around for us.
I hope you have familiarized yourself with the CECT results I posted. They are unable to pick anything in the name of a benign or a malignant tumor. The part that is darker than the normal liver when exposed to CECT examination behaved like a normal liver. This is what prompted my Radiologist to say " we have good news and bad news for you Anthony. Good news, it is not a tumor. Bad news, we don’t know what it is. Probably, a biopsy will tell us."
Yes, I did a biopsy on Tuesday and the experience is not what I hear from others. After everything, the doctor demanded I lie for one hour compressing the side and site of insertion. The pain on my shoulder blade was too sharp to bear. I will never miss it.
Otherwise, I am waiting for the results within ten days. I don’t know what to expect. My fingers are closed and as Joan Block says, is this the time I will be told the worse.
I will keep you posted. Meanwhile let’s pray together.
Kinoti

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Hi Tsbs
I have walked with you for sometime. I remember you had taken a biopsy because of your steatosis and hep b infection. I have longed to hear your progress and would appreciate if you update us.
Meanwhile, I wish you all the best of luck.
Kinoti

Just saw the liver biopsy result which is metavir score F3A2. The pathologist diagnosis was moderate necroinflammation and moderate fibrosis and also NAFLD Brunt score 8/9.
Will see my gastroenterologist next week to commence treatment.
My hope and prayer is that it will regress on treatment.

I don’t know what brunt score of 8/9 is, I have searched online to no avail. Anybody with idea should let me know.

Hi @Tsbs
I must admit that I am extremely happy to hear your progress.
I can assure you steatosis and fibrosis are reversable from my own personal experience. You just need some small discipline. Eat well and exercise.
Some of the expressions in your medical report are strange to me. I am looking forward to somebody expounding them for us.
Kinoti

Dear @Tsbs,

The Brunt scoring system is a way to trying to determine the severity of fatty liver disease: https://aspe.vb.it/it/downloads/Brunt%20classificazione%20NASH.pdf. This way you can more objectively know if it is getting better or worse.

Thomas