Ultrasound report understanding

[Gill2018]

I left tenofovir in Mid October after taking 5 years without seeing the doctor.

Last week, I went to doctor and he asked me lot of blood tests.
All were fine but
ALT: 114
AST: 43
Both were high.
Cholesterol: 3.77 (range: 3.8-5.2)
The rest all test including CBC was normal.

Hep B surf Ab - hep b virus surface Ab(F) - reactive

Ultrasound report: the gallbladder, bile ducts, spleen and kidneys are normal in appearance.
There is hyperechoic, oval, smoothly-marginated, solid mass noted in the right lobe of liver laterally, measuring 1.3 cm * 1.3cm * 1.2 cm. The remainder of the liver is normal in appearance.

Interpretation:
1.3cm probable benign cavernous hemangioma in the right lobe of the liver. Follow up ultrasound recommended after 3 months.

Is this scaring? My family doctor has referred me to gastronologist than I can go for further liver test. System is very slow here so little worried. Please advise friends

[StephenCastlecrag]

Benign hemangioma is not uncommon, but you will need to have it confirmed by further imagining examination. You should also check your AFP. Your ALT is high, so you will need to check your hbvdna and HBeAg status.

[Gill2018]

Thanks sir. Here in Canada I cannot do anything without physician prescription and process is time taking. That’s making me scaring.

[StephenCastlecrag]

GPs should be able to order the test for AFP and hbvdna. They may also be able to refer you to an Imaging centre to do a CT or MRI investigation of the Hemangioma. When you do see your Gastro specialist, he/she most probably will order the same tests. You can also try the outpatient department of a public hospital. Talk to your family doctor.

[living_with_hepb]

@gill - I am bit confused about your results. ALT/AST is high but you are HbsAb Reactive which means you have antibodies to HBsAG which means, you may have cleared Hbsag and virus shouldn't be multiplying. I would expect HBV DNA to be either undetectable or very low.  If it's not the Hepatitis B that causing a raised ALT, look for other causes. Alcohol, non alcoholic fatty liver etc. I am sure your GP is looking at that and your gastroentrologist should def look at all other possibilities.

Please double check the report that it's in fact: HBsAb Reactive.

Also, as Stephen mentioned, get the AFP blood test as soon as possible and don't wait for 3 months before getting another ultrasound to see interval changes. If AFP is <2, it might very well be an hemangioma. Hemangiomas are relatively common esp in women who have/had used birth control pills in the past.

Ask your GP to get a follow up CT.
1.3 cm is too small to be clearly seen and identified on MRI,
and classified on MRI but CT are more accurate at defining hemangiomas.