What Do These Blood And Ultrasound Reports Indicate?

Posted on Sat, 5 Dec 2015

Question: Over the past 6 months, I have had spells of dizziness, some mild fatigue and some head zaps. I recently developed some abdominal discomfort and saw a gastro. Blood tests and an ultradsound of the abdomen show a slightly enlarged spleen and the following elevated markers:
Ferritin Level (308ng/ml)
MCH (33pg)
From what I have read, there is a probability of Lymphoma, ANxiety or any number of issues. My question is, what is considered elevated enough with Ferritin levels to suggest lymphoma or what else should I look for to determine what is going on with me.
More information for this question from the Ultrasound:

The liver measures 17.6 cm. There is coarsened echotexture from fatty infiltration.
There is hepatopedal portal flow.
The portal vein measures 1.0 cm.
The gallbladder is normal.
No evidence for gallstones.
The gallbladder wall is 2.2 mm.
Common hepatic duct is normal and measures 4.3 mm.
Pancreas is not well detailed.
The spleen is normal and measures 14.6 x 6.2 x 7.1 cm.
Right kidney is 10.8 cm.
Left kidney is 12.4 cm.
There is no free fluid.
Aorta and IVC are normal, as visualized.
The patient was not tender during the exam.

IMPRESSION:
1. Fatty liver.
2. Enlarged spleen.
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Answered by Dr. Indranil Ghosh (5 hours later)

Brief Answer:
does not look like lymphoma

Detailed Answer:
Hi

Thanks for your query.

Ferritin is a very non-specific marker. It can be elevated in many conditions including liver disease. Overall, I don't see any possibility of lymphoma here.

The ultrasound findings suggest some degree of chronic liver disease probably due to fatty liver.

I feel that the hematology consult will not reveal anything more.

The liver problem can be taken care of by medicines and lifestyle changes.

Hope this helps.
Regards

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

Follow up: Dr. Indranil Ghosh (1 hour later)

Thank you for the response. It the size of the spleen a concern and could it be attributing to the abdominal soreness ?

Answered by Dr. Indranil Ghosh (59 minutes later)

Brief Answer:
no not of concern

Detailed Answer:
The spleen is only mildly enlarged, not huge or something close to that. It is not of major concern and definitely it is not of enough size to cause abdominal soreness.

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

Follow up: Dr. Indranil Ghosh (25 hours later)

Doctor. I was sitting in my chair tonight and found swollen lymph nodes on my left elbow. Is this bad? Does this point to cancer?

Answered by Dr. Indranil Ghosh (15 minutes later)

Brief Answer:
if really swollen then would require evaluation

Detailed Answer:
Small lymph nodes are normal. But if they are really swollen, like >1.5-2 cm then we need to evaluate. Common causes are infection, especially viral or bacterial.

If the examining doctor feels, he may order a course of antibiotics or fine needle aspiration. Cancer is one of the causes but should not think of it right away before ruling out common causes.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Indranil Ghosh (7 hours later)

Thank you. My cbc tested seemed normal last week woudlnt that point away from cancer? Rbc/wbc normal?

Answered by Dr. Indranil Ghosh (3 hours later)

Brief Answer:
yes, that points away from cancer

Detailed Answer:
As I have already said, probability of cancer is very low in your case.

There is no cause for worrying so much.

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

Follow up: Dr. Indranil Ghosh (8 hours later)

Doctor. Here is the latest lab results from this week. Do these high numbers mean anything to you

Answered by Dr. Indranil Ghosh (1 hour later)

Brief Answer:
seems fine

Detailed Answer:
This hemogram looks pretty much normal to me.

Those values which you have referred to as high are to be considered normal only

Note: For further queries related to kidney problems Click here.

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