Ultrasound yesterday said I might have cirrhosis and cancer, i am SVR from year 2008

[JackABCD]

All tests that I did recently before Ultrasound and were OK - CT, another ultrasound and Fibroscan.
I don't feel well since I took Covid vaccine.
My right abdominal became slightly bigger.
Can it be ? Can it be that ultrasound results are misleading?
I am going also to do CT next week.

[flyinlynn]

Ok I found something

Portal vein thrombosis is blockage or narrowing of the portal vein (the blood vessel that brings blood to the liver from the intestines) by a blood clot.

I think you might want to read up on portal vein thrombosis.

“ What are common risk factors of PVT?

Blood clots are more likely to form when the blood flows irregularly in the body. While doctors typically don’t know what causes portal vein thrombosis, there are a number of risk factors for developing this condition.

Some of the most common include:

inflammation of the pancreas
appendicitis
naval infection from the umbilical cord stump in infants
polycythemia, or excess red blood cells
cancer
oral contraceptives
cirrhosis of the liver
liver disease
trauma or injury”

[flyinlynn]

Have you done anything else that could harm your liver since you were cured of hep C back in 2008 like being overweight (Fatty liver disease) or drinking to excess? Is it possible your cure didn’t stick or you became reinfected with hep c?

If you didn’t have significant liver damage from hep c before your cure in 2008 and you remain cured  and have nothing else causing liver damage I can’t see how you would have liver cirrhosis. Although there are other conditions that can also cause liver damage other than the ones I just listed.

What exactly did your ultrasound say? Cirrhotic appearance of the liver? Echogenic mass?

Ultrasound can give indications of cirrhosis but it’s not the final word on diagnosis of cirrhosis by any means.

Have you been followed since you were cured? Have you been having routine ultrasounds since you were cured?

Best of luck to you

[JackABCD]

Here is the report from the  abdominal ultrasound 3 days ago:Liver - Enlarged at the expense of the left lobe and caudate lobe with atrophy of the right lobe. Has irregular borders and uneven texture,
Caudate lobe - the whole is grasped by an uneven process about 7 cm in diameter.Liver Dopler - An enlarged portal vein with a clot.No flow was demonstrated in the SMV and distal SV.
In the proximal SV free flow was indeed demonstrated.
Spleen - Enlarged, about 18 cm long. Normal texture.
All the rest is OK.Conclusions and recommendations - Liver cirrhosis with enlargement of the caudate lobe and impression of a clumsy process in the caudate lobe.
PVT.Splenomegaly.
Recommendation - Perform trapezoidal abdominal CT as soon as possible and pathological follow-up.

To you questions - I am not drinking at all.
a SVR since 2008 after one year with Interferon ad Riba.

I am uner followup all along the years, doing CT an Ultrasound every 18 months on average.
Fibroscan 6 months ago said Fibrosis 2-3,
It was 3-4 on 2008.
CT and ultrasounds from last 12-18 said that the liver is fatty and that's all. CT Abdominal and pelvic entrography from 18 months ago also said that spleen is little bit enlarged, Ultrasound  for Kidneys and urinary from Dc 2020 that liver is fatty and spleen is enlarged to 15 cm.

The radiologist that made that last ultrasound is considered as a good one.

What do you think?
How to take this last ultrasound results ?
I am shocked.
What is the chance that CT that I am going to do next week will provide a different picture ?

Thank you.

[flyinlynn]

A little about my story. I had hep c probably infected in 1978. I treated three times with interferon based treatments but was a null responder. I was having liver biopsies every 5 years each one had a higher fibrosis score. I was diagnosed with liver cirrhosis via liver biopsy in January 2008. I treated me hep c in 2014 when the new generation hep c meds started arriving on the scene but relapsed. I treated again with Harvoni and ribavirin for 24 weeks finished treatment in May 2015 and was finally cured on this my fifth treatment. But by that time I had had cirrhosis for 7 years.

I had only been having abdominal ultrasounds and blood testing every six months except for a couple of upper endoscopies looking for esophageal varicies. I did end up developing grade 3 varicies that needed to be banded back in 2012.

So anyway for my my last abdominal ultrasound showed two echogenic masses that were not seen on previous imaging so I had my first CT scan to try to determine what the masses are. The result was indeterminate so I’m having a repeat CT after 3 months. So at this point I hoping it’s not HCC.

So I’m kind of surprised at the level of follow up they have done with you since you didn’t have liver disease when you were cured of hep c but at least they are finding things sooner than later.

Having fatty liver is NAFLD can in itself cause liver disease. As there are more and more people being overweight these days there has been a proportionate rise in NAFLD. I’m not a doctor just a patient but I’m thinking what ever might be going on with you could be related to having fatty liver. Since you have an enlarged spleen I’m wondering how your platelet count is doing. My low platelet count was the first symptom I developed that indicated I have worsening liver disease. Normal platelets are above 150 and mine weee before my hep c was cured was around 85. Now 6 years post cure they’re around 110.  Still low but improved. Also my spleen is now apparently only slightly enlarged.

Apparently being morbidly obese isn’t required to develop NAFLD although the more overweight one is the greater odds of developing NAFLD. I guess there are people who aren’t very overweight who develop NASH and NAFLD.

There are there conditions that can also cause liver disease and cirrhosis like Liver disease caused by your body's immune system (autoimmune hepatitis)
Destruction of the bile ducts (primary biliary cirrhosis)
Hardening and scarring of the bile ducts (primary sclerosing cholangitis

Also cirrhosis can be from unknown cause  cryptogenic cirrhosis.

I totally understand you feeling shocked. I don’t know if your up coming CT scan will give you better news but I hope it does. Or at least at your testing will give you clarity about what is going on with your health.

[JackABCD]

Just to add,
Blood test about 3 months ago show first time in my life lower then normal Fe-Iron, then 2 months ago I got the
Pfizer Covid vaccine and I started to feel bad since then.
Most doctors here don't think that there is any relation with
the Covid vaccine. Also I am not sure, it is just how things happened in my case.

[JackABCD]

Just to add,
Blood test about 3 months ago show first time in my life lower then normal Fe-Iron, then 2 months ago I got the
Pfizer Covid vaccine and I started to feel bad since then.
Most doctors here don't think that there is any relation with
the Covid vaccine. Also I am not sure, it is just how things happened in my case.

[flyinlynn]

Dunno they don’t check my Fe-iron levels.

I agree with your doctors about the lack of correlation between receiving the Covid vaccine and your symptoms. But I’m just a fellow patient and do not work in the medical field.