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Suggest Treatment For Lesions In The Liver

Posted on Mon, 7 Aug 2017

Question: Hii,

My mother in law is 65 years old. She had developed a lesion in liver last year, which has increased in size now. Please find attached her MRI reports.. Please let me know what does the results in report mean.

Regards,
XXXX

Answered by Dr. Ramesh Kumar (26 hours later)

Brief Answer:
Biopsy should be done.

Detailed Answer:
Hello XXXXXXX
Thanks for choosing HealthcareMagic for your query.
I am a Gastroenterologist and would be answering your query.

As per your query answers are-

See a MRI picks up water molecules in a particular part of body and splits it by using strong magnetic field.
When a particular organ is functioning normally,Blood flow to that organ is normal hence water contents of that part would also be normal.
When due to fibrosis or any oher condition blood flow in a particular area decreases the water contents of that area also decreases hence causing a hypointense image. Hemangioma and focal nodular hyperplasia are among the most common hypointense images.

However in case of cancerous masses where the number of cells increases and there is a rapid multiplication of cells the blood flow to particular area increases leading to increased water contents.Hence on MRI we get hyperintense images.

In you case a particular lobe in liver shows hyperintense images while other lobe shows hypointense images.
Only a biopsy or Fine needle aspitration cytology test can suggest the exact nature of lesion.

What has your primary consulatant at ILBS suggested to you?

I would have suggested her to go for a Needle aspiration(Ultrasound guided) or a Biopsy test.

Thanks.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Ramesh Kumar (23 minutes later)

Hii Sir,

Thank you for your explanation. We had met Dr. Sarin at ILBS. He had asked us to get MRI done along with couple other tests and get back to him on 26th of this month.

Hence, I thought to take help from you in understanding the MRI Report. Sir, i still have few queries regarding the MRI report. If you look into the 2nd page of the report, under the topic impression: it says a large lesion segment with HCC, and a small lesion which can either be HCC or hemangioma (non-cancerous). As per what i have read, HCC is a primary malignancy. So does this report confirms malignancy or suggests malignancy?

Answered by Dr. Ramesh Kumar (2 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Answer 1-it says a large lesion segment with HCC-
In medical language-current MRI techniques and criteria for diagnosing hepatocellular carcinoma have evolved to rely most heavily upon the use of gadolinium-based contrast agents. Current established criteria for diagnosing HCC are based primarily on the extracellular properties of contrast agents.

In simple words yes MRI with contrast is used to diagnose Hepatocellular carcinoma but confirmation can be done only after biopsy(however MRI is almost 99% sensitive to rule out HCC).

Going by books- It is suggestive of malignancy however frankly speaking its malignancy.
Stage of HCC can be confirmed by Biopsy.Biopsy is an examination of tissue removed from a living body to discover the presence, cause, or extent of a disease.
However in the next lobe MRI is not able to differenciate between HCC and other benign mases therefore a biopsy of that lesion should be done in segment 2.
Dr Sarin is among top 2 Gastro's in XXXXXXX
Follow whatever he suggests.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Ramesh Kumar (20 minutes later)

Thank you sir for your advice. We will definitely proceed with Dr Sarin's suggestion.

Answered by Dr. Ramesh Kumar (5 minutes later)

Brief Answer:
good luck.

Detailed Answer:
Good luck and hope she get well soon.

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng