ZocdocAnswersScared and confused 54yr old women with Nash/Cirrhosis

Question

Scared and confused 54yr old women with Nash/Cirrhosis

While having lapband surgery my Dr. did a biopsy on my liver and now have cirrhosis. I have since followed up with a hepatologist who had me go for an MRI. I gota copy of the report which states "Cirrohtic liver, peripheal reticular fibrosis. No portal hypertension or HCC. 9 mm arterial enhancing lesion without portal venous washout or T2 signal abnormalitylikely arterio-portal shunt. Also my spleen is in the upper limits of normal 12.6 greatest dimension no ascites. There are prominent periportal and portacaval lymph nodes measuring up to 1.2 cm which are likely reactive in the setting of chronic liver disease.There are no varices or ascites." Correlation with AFP levels as well as short term follow up mri in 3-6 months with Eovist MRI recommended for confirmation. First my doc says we will watch it come back in 6 mths.next day I call and ask if we can check in 3 mths she says the lesion is not a risk. Can you please explain these results and do you agree with my dr.

Answer

I'm sorry to hear that you are dealing with this issue and the sudden flood of information! I definitely recommend that you sit down with both your primary care doctor and your gastroenterologist, so that you can get answers to your questions and get a straight answer on what you need to do at this point. Although not totally clear from the information that you provided, it sounds like you previously carried a diagnosis of NASH and that this has now progressed to cirrhosis, which means that there is now evidence of scarring in the liver. The first thing I would recommend talking about with your doctor is making sure that other causes of cirrhosis, other than NASH, have all been ruled out. This may have already been done, but if not it is very important! The next set of recommendations about repeated the scan and AFP levels are done to watch out for a liver tumor in the setting of liver cirrhosis, which increases your risk of developing a tumor. It does sound like the "9 mm lesion" that you have is unlikely to be a tumor. However, this repeated screening is pretty standard for all patients with cirrhosis, so would be likely repeated regardless. Talk to your doctor for more information!

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