I took the plunge and got a biopsy. Here are my results Please any feedback will be greatly appreciated
skewedButNotBroken said
Jan 10, 2014
I want to thank everyone who has replied to my post. I'm now looking for a new gastro. He is useless and put me through a lot of stress thinking I had cirrhosis. When he gave me these results he spent 3 minutes with me, charged my insurance company 300 bucks and I had to pay a $60 copay. After reading the replies here I now completely understand what he (the gastro) should have told me. Again thank you good people.
I'm not really surprised my hep c has not regressed. I am obsessed with health. I go to extremes that most people would never think of. For example, if I walk through a parking lot and I smell a car producing toxic fumes, I hold my breath. I do not use lotions, perfumes or anything on my body that could possible be toxic. When I cut my grass I wear a mask, I eat and drink organic, I exercise my mind, body and soul. My addictive nature caused me to be infected with hep c many years ago, but now this same addictive nature is keeping me alive and well because I go to extremes!
I'll close for now, it's time for my milk thistle and Liv.52 meds. Thanks again!
Tig said
Jan 10, 2014
Hello Testiva,
Indeed your biopsy shows minimal damage to your liver. That's good news for sure! Without sounding like a pathologist, I'll try to describe what your report says and another member may expand on my explanation. Here goes:
The biopsy was done using a CT machine to provide information to the physician. It provides an an accurate scan of the liver to show the doctor where to place the biopsy needle. It simply provides an extra level of safety for the procedure.
Grade 2 of 4 (mild portal hep w/o limiting plate necrosis and rare necrotic hepatocytes): This is the level of liver inflammation found in the biopsied tissue. Often I've seen this score preceded by the letter "A" (for inflammation in this case). So your score would be written as "A-2". It says you have mild portal hepatitis or mild portal inflammation and rare damaged hepatocytes (liver cells). When the liver inflames, the various cells that make up the liver and liver architecture go through changes and can move into areas they normally don't. Reduce the inflammation and correct the infiltration of these cells. Your level of inflammation is basically "Medium". Simple but accurate.
Stage 1 of 4 (negative/mild for fibrosis and cirrhosis): This is the amount of fibrosis found in your liver. In your case the biopsy shows a 1, but the score starts at 0. A F-1 indicates some fibrosis, but your doctor claims 1 means none. I would get that clarified. Like the inflammation score, the fibrosis score has a letter that usually precedes it. In this case it's an "F" (for fibrosis). Your score would be written as "F-1". This is particularly good news for you. The higher that score, the more fibrosis is present and when you reach F-4, you've got "cirrhosis" of the liver, which is simply advanced fibrosis. You currently have very small indication of fibrosis.
The bile ducts are the pathways through the liver, that channel the bile to the Gall Bladder. It discharges collected bile into the small intestine to aid with digestion. Your bile ducts are clear and patent. GRANULOMA (granulomata, granulomas):A tumor composed of granulation tissue resulting from injury, inflammation or infection. You didn't have evidence of that. So there was nothing found following examination. More good news!
The stains that are mentioned are simply types of dye they use on the liver samples from the biopsy. When dyed they show various architecture and changes to it at times. Different stains show different conditions, and can show evidence of high iron levels in the liver and subsequently a reason for high iron blood levels. You don't show any evidence of high iron stores in your liver. Good news again!! All of your stains were normal. If you want to know more you can Google it or let me know and I'll send you some additional info.
All in all, your biopsy was pretty good. You've got some inflammation, but that's because you've got hepatitis! HEPA = Liver TITIS (itis) = Inflammation. Since HCV is a slowly progressive disease, that can take many decades to get worse, a biopsy like yours is good news. It gives you the knowledge that your liver health/condition is pretty good and you've got time to treat without fear of fibrosis or cirrhosis becoming a treatment concern in the immediate future. A healthier liver accepts treatment better they say and I believe that as well.
I hope that helps you understand it a little better and in easier terminology. If I can better explain something, let me know.
Best, Tig
mallani said
Jan 10, 2014
Hi Testiva,
Your report translates into A2,F1. This is good. I don't quite understand why the Pathologist says 'no fibrosis' then gives Stage 1 (F1), which means portal fibrosis. A2 means moderate inflammation, which means the fibrosis will progress.
I notice you had a previous biopsy 11 years ago, which showed F1. It's very unusual to have no progression over that length of time, particularly when your doctor said you were cirrhotic from your labs. Sounds strange.
What does your doctor say now? Cheers.
lauralou57 said
Jan 9, 2014
Wow!
This doesn't look too bad but it has much more detail than my biopsies have had so someone else with more understanding will have to speak up.
skewedButNotBroken said
Jan 9, 2014
Liver CT guided needle biopsy
Chronic hepatitis C
Grade 2 of 4 (mild portal hepatitis without limiting plate necrosis and rare necrotic hepatocytes).
Stage 1 of 4 (negative for fibrosis and cirrhosis)
Three levels show liver with intact lobular architecture. Central veins are present and intact. Hepatocytes are essentially unremarkable with no inflammation in the lobule and no fatty change. A rare necrotic hepatocyte is identified. Portal areas are expanded by a lymphoid infiltrate but there is no limiting plate necrosis. Bile ducts are present and intact. There are no granulomata. The iron stain shows no increase of stainable iron stores. The trichome stain is negative for peri-portal fibrosis., septal fibrosis and cirrhosis. The reticulin stain highlights normal trabecular architecture. The PAS stains with and without diastase show no PAS positive, diastase resistaant, PAS positive material within hepatocytes cytoplasm. DMR/em
GROSSS:
The specimen is received fresh in a single container labeled with the patient's name, CSN number and submitted as "liver biopsy" are multiple yellowish tan needle core biopsies measuring 1.4 x 0.3 x 0.1 cm in aggregate. Entirely submitted in one cassette. TS1. CC/mjf
I want to thank everyone who has replied to my post. I'm now looking for a new gastro. He is useless and put me through a lot of stress thinking I had cirrhosis. When he gave me these results he spent 3 minutes with me, charged my insurance company 300 bucks and I had to pay a $60 copay. After reading the replies here I now completely understand what he (the gastro) should have told me. Again thank you good people.
I'm not really surprised my hep c has not regressed. I am obsessed with health. I go to extremes that most people would never think of. For example, if I walk through a parking lot and I smell a car producing toxic fumes, I hold my breath. I do not use lotions, perfumes or anything on my body that could possible be toxic. When I cut my grass I wear a mask, I eat and drink organic, I exercise my mind, body and soul. My addictive nature caused me to be infected with hep c many years ago, but now this same addictive nature is keeping me alive and well because I go to extremes!
I'll close for now, it's time for my milk thistle and Liv.52 meds. Thanks again!
Hello Testiva,
Indeed your biopsy shows minimal damage to your liver. That's good news for sure! Without sounding like a pathologist, I'll try to describe what your report says and another member may expand on my explanation. Here goes:
The biopsy was done using a CT machine to provide information to the physician. It provides an an accurate scan of the liver to show the doctor where to place the biopsy needle. It simply provides an extra level of safety for the procedure.
Grade 2 of 4 (mild portal hep w/o limiting plate necrosis and rare necrotic hepatocytes): This is the level of liver inflammation found in the biopsied tissue. Often I've seen this score preceded by the letter "A" (for inflammation in this case). So your score would be written as "A-2". It says you have mild portal hepatitis or mild portal inflammation and rare damaged hepatocytes (liver cells). When the liver inflames, the various cells that make up the liver and liver architecture go through changes and can move into areas they normally don't. Reduce the inflammation and correct the infiltration of these cells. Your level of inflammation is basically "Medium". Simple but accurate.
Stage 1 of 4 (negative/mild for fibrosis and cirrhosis): This is the amount of fibrosis found in your liver. In your case the biopsy shows a 1, but the score starts at 0. A F-1 indicates some fibrosis, but your doctor claims 1 means none. I would get that clarified. Like the inflammation score, the fibrosis score has a letter that usually precedes it. In this case it's an "F" (for fibrosis). Your score would be written as "F-1". This is particularly good news for you. The higher that score, the more fibrosis is present and when you reach F-4, you've got "cirrhosis" of the liver, which is simply advanced fibrosis. You currently have very small indication of fibrosis.
The bile ducts are the pathways through the liver, that channel the bile to the Gall Bladder. It discharges collected bile into the small intestine to aid with digestion. Your bile ducts are clear and patent. GRANULOMA (granulomata, granulomas):A tumor composed of granulation tissue resulting from injury, inflammation or infection. You didn't have evidence of that. So there was nothing found following examination. More good news!
The stains that are mentioned are simply types of dye they use on the liver samples from the biopsy. When dyed they show various architecture and changes to it at times. Different stains show different conditions, and can show evidence of high iron levels in the liver and subsequently a reason for high iron blood levels. You don't show any evidence of high iron stores in your liver. Good news again!! All of your stains were normal. If you want to know more you can Google it or let me know and I'll send you some additional info.
All in all, your biopsy was pretty good. You've got some inflammation, but that's because you've got hepatitis! HEPA = Liver TITIS (itis) = Inflammation. Since HCV is a slowly progressive disease, that can take many decades to get worse, a biopsy like yours is good news. It gives you the knowledge that your liver health/condition is pretty good and you've got time to treat without fear of fibrosis or cirrhosis becoming a treatment concern in the immediate future. A healthier liver accepts treatment better they say and I believe that as well.
I hope that helps you understand it a little better and in easier terminology. If I can better explain something, let me know.
Best, Tig
Hi Testiva,
Your report translates into A2,F1. This is good. I don't quite understand why the Pathologist says 'no fibrosis' then gives Stage 1 (F1), which means portal fibrosis. A2 means moderate inflammation, which means the fibrosis will progress.
I notice you had a previous biopsy 11 years ago, which showed F1. It's very unusual to have no progression over that length of time, particularly when your doctor said you were cirrhotic from your labs. Sounds strange.
What does your doctor say now? Cheers.
Wow!
This doesn't look too bad but it has much more detail than my biopsies have had so someone else with more understanding will have to speak up.
Liver CT guided needle biopsy
Chronic hepatitis C
Grade 2 of 4 (mild portal hepatitis without limiting plate necrosis and rare necrotic hepatocytes).
Stage 1 of 4 (negative for fibrosis and cirrhosis)
Three levels show liver with intact lobular architecture. Central veins are present and intact. Hepatocytes are essentially unremarkable with no inflammation in the lobule and no fatty change. A rare necrotic hepatocyte is identified. Portal areas are expanded by a lymphoid infiltrate but there is no limiting plate necrosis. Bile ducts are present and intact. There are no granulomata. The iron stain shows no increase of stainable iron stores. The trichome stain is negative for peri-portal fibrosis., septal fibrosis and cirrhosis. The reticulin stain highlights normal trabecular architecture. The PAS stains with and without diastase show no PAS positive, diastase resistaant, PAS positive material within hepatocytes cytoplasm. DMR/em
GROSSS:
The specimen is received fresh in a single container labeled with the patient's name, CSN number and submitted as "liver biopsy" are multiple yellowish tan needle core biopsies measuring 1.4 x 0.3 x 0.1 cm in aggregate. Entirely submitted in one cassette. TS1. CC/mjf