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What Do These Lab Reports Indicate?
Question: Hi,
I have been having regular ultrasounds for gallbladder. However, recent findings showed lesions in liver.
1. Can you please explain what the reports mean? Hyperechoic foci? diffusely echogenic vs central? Cortial kidney cyst?
2. What and why could cause the lesions? eating/lifestyle/genetics?
I do not smoke/drink. I exercise regularly. My recent blood work for CBC and liver enzymes and cholesterol were normal. ONly my eGFR was low.
I do eat meat, almonds.
Aug 2017: Comparison to July 2016 u/s. Findings: 3 hyperechoic foci are identified within the liver. One in segment 6 measuring 2.5x1.4.2.1 cm, stable in size since previous, however its sonographic characteristics have changed, as it is diffusely hyperechoic today, demonstrating central hyperechogenicity 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 with 5mm polyp. Pancreas/spleen/left kidney are normal. Right kidney demonstrates 5mm cortical cyst.
Impression: Dominant hyperechoic lesion within liver is overall stable in size, however its sonographic characteristics have changes, as described above. Two new hepatic lesions identified. Given findings, further assessment recommended for further characterization.
PREVIOUS ultrasound reports:
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.
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.
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.
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
I have been having regular ultrasounds for gallbladder. However, recent findings showed lesions in liver.
1. Can you please explain what the reports mean? Hyperechoic foci? diffusely echogenic vs central? Cortial kidney cyst?
2. What and why could cause the lesions? eating/lifestyle/genetics?
I do not smoke/drink. I exercise regularly. My recent blood work for CBC and liver enzymes and cholesterol were normal. ONly my eGFR was low.
I do eat meat, almonds.
Aug 2017: Comparison to July 2016 u/s. Findings: 3 hyperechoic foci are identified within the liver. One in segment 6 measuring 2.5x1.4.2.1 cm, stable in size since previous, however its sonographic characteristics have changed, as it is diffusely hyperechoic today, demonstrating central hyperechogenicity 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 with 5mm polyp. Pancreas/spleen/left kidney are normal. Right kidney demonstrates 5mm cortical cyst.
Impression: Dominant hyperechoic lesion within liver is overall stable in size, however its sonographic characteristics have changes, as described above. Two new hepatic lesions identified. Given findings, further assessment recommended for further characterization.
PREVIOUS ultrasound reports:
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.
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.
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.
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
Brief Answer:
Hemangiomas as explained in details, cancer should be ruled out
Detailed Answer:
Hi.
Thanks for your query.
Noted the history and serial reports and understood your concerns.
To answer your specific queries:
1. Can you please explain what the reports mean? Hyperechoic foci? diffusely echogenic vs central? Cortical kidney cyst?
These reports mean the following:
August 15 report has already mentioned this to be a hemangioma. Hemangioma is a bunch of enlarged blood vessels ans is not uncommon to appear in liver.
Hyperechoic means it is more pronounced as seen on the screen and is one of the characteristic of hemangioma although varied echogenicity depending upon the internal condition can appear.
This can be confirmed by Contrast enhanced CT scan and such investigations as may be advised by the Radiologist.
Development of additional lesions can be due to hemangiomas.
Technical details are difficult to understand for a clinician but most important is to know the diagnosis and get this confirmed by appropriate further investigations.
In suspected hemangioma FNAC is best avoided.
The cortical small cyst may be a benign lesion as seen and as mentioned in the present scan.
There is gall bladder polyp and may most probably be a benign one but may best be confirmed by Cholecystectomy for histo-pathology and SC scan would show the picture better than an ultrasound hence discuss and request for advanced investigations.
Another reasons for believing these to be benign is very slow progression as per the serial ultrasounds over 2 years. Cancer would have grown far faster and would have detrimental by this time, although should always be ruled out.
2. What and why could cause the lesions? eating/lifestyle/genetics?
There is no definite known cause of such lesions and unless proved otherwise should always be confirmed by further investigations and procedures as would be advised by your Surgeon in second opinion. Eating, lifestyle or genetics may not be related to such lesions.
I hope this answers your queries with explanation.
Please feel free to ask for further relevant queries if you feel that there is a gap of communication.
Hemangiomas as explained in details, cancer should be ruled out
Detailed Answer:
Hi.
Thanks for your query.
Noted the history and serial reports and understood your concerns.
To answer your specific queries:
1. Can you please explain what the reports mean? Hyperechoic foci? diffusely echogenic vs central? Cortical kidney cyst?
These reports mean the following:
August 15 report has already mentioned this to be a hemangioma. Hemangioma is a bunch of enlarged blood vessels ans is not uncommon to appear in liver.
Hyperechoic means it is more pronounced as seen on the screen and is one of the characteristic of hemangioma although varied echogenicity depending upon the internal condition can appear.
This can be confirmed by Contrast enhanced CT scan and such investigations as may be advised by the Radiologist.
Development of additional lesions can be due to hemangiomas.
Technical details are difficult to understand for a clinician but most important is to know the diagnosis and get this confirmed by appropriate further investigations.
In suspected hemangioma FNAC is best avoided.
The cortical small cyst may be a benign lesion as seen and as mentioned in the present scan.
There is gall bladder polyp and may most probably be a benign one but may best be confirmed by Cholecystectomy for histo-pathology and SC scan would show the picture better than an ultrasound hence discuss and request for advanced investigations.
Another reasons for believing these to be benign is very slow progression as per the serial ultrasounds over 2 years. Cancer would have grown far faster and would have detrimental by this time, although should always be ruled out.
2. What and why could cause the lesions? eating/lifestyle/genetics?
There is no definite known cause of such lesions and unless proved otherwise should always be confirmed by further investigations and procedures as would be advised by your Surgeon in second opinion. Eating, lifestyle or genetics may not be related to such lesions.
I hope this answers your queries with explanation.
Please feel free to ask for further relevant queries if you feel that there is a gap of communication.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Please post report of MRI
Detailed Answer:
FNAC means fine needle aspiration cytology.
Not to be done if hemangioma is suspected as it can bleed.
Low gfr should be investigated further.
It is good that blood work up was normal for CBC and liver enzymes.
Please post the report of MRI.
Please post report of MRI
Detailed Answer:
FNAC means fine needle aspiration cytology.
Not to be done if hemangioma is suspected as it can bleed.
Low gfr should be investigated further.
It is good that blood work up was normal for CBC and liver enzymes.
Please post the report of MRI.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Kampana
Answered by
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