I was stage 0 at 2001 by then 2013 cirrhosis had started. guess it just depends on one's self. we are all uniquely different for sure. glad u got to a hepa.. I love mine.. he always gives me thumbs up!! lol that means a whole lot to me. just like the text my granddaughter sent me. I might post what she told me. I had to have a box of Kleenex. lol she is so smart & I love her so much for giving me much needed support.i sure want to be able to see at least one softball game this yr. she is in fast pitch & is very good. already have miss state coach looking at her. she is only 13.. lol makes me & her mom & dad & rest of family very proud. she is not a quitter so I just got to do what she does.. my role model.. <3
mallani said
Jun 2, 2014
Hi Testiva,
Thanks for the reports. They are pretty good and concise. There should be a comment at the start, describing the specimen. It may be called 'Macroscopic', and would say something like 'The specimen consists of 2 cores of tissue measuring 3 cm in length'. It gives a good idea of whether the specimen is adequate.
You do not have cirrhosis, despite any Blood test abnormalities. You are very lucky that your fibrosis progression is slow. I went from F1 to F3-4 in less than 10 years. Despite the fact that biopsy only samples one or two liver segments, it is impossible to have an intact limiting plate in one segment and cirrhosis in another.
Hepatologists like to allow one stage , so you are F2 at worst. You could afford to wait for Sovaldi/Ledipasvir. Best of luck, and let us know the result of the slide review, although it seems pretty clear.
Cinnamon Girl said
Jun 2, 2014
Hi Testiva, thanks for posting your latest biopsy report which indicates that you don`t have cirrhosis. It would be interesting if you could let us know what the pathologist says when he`s examined the slides, and also post any other blood results you get.
Sorry you`re suffering badly from fatigue, that could certainly be a symptom of Hep C and it is possible to feel dreadful even without having cirrhosis. You may well find that once you`ve done treatment you`ll feel a lot better all round.
-- Edited by Cinnamon Girl on Tuesday 3rd of June 2014 11:05:00 AM
skewedButNotBroken said
Jun 2, 2014
Results from 12/09/2002
SURGICAL PATHOLOGY
DIAGNOSIS
1. LIVER BIOPSY:
CHRONIC HEPATITIS C
MILD LOBULAR AND PORTAL HEPATITIS WITH NO HEPATOCELLULAR NECROSIS AND NO LIMITING PLATE NECROSIS
(GRADE I/IV).
NO FIBROSIS OR CIRRHOSIS (STAGE I/IV).
NO INCREASE IN STAINABLE IRON STORIES
THREE LEVELS SHOW LIVER WITH INTACT LOBULAR ARCHITECTURE. CENTRAL VEINS ARE PRESENT AND INTACT. HEPATOCYES ARE ESSENTIALLY UNREMARKABLE. THERE IS NO FATTY CHANGE AND NO HEPATOCELLULAR NECROSIS
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
mallani said
Jun 1, 2014
Hi Testiva,
It's important to keep a copy of all your test results.
If you were F1 by biopsy 12 years ago, I doubt whether you'd still be F1, especially as the ALT indicates continuing inflammation. Is it possible to post a copy of the recent biopsy report? Cheers.
Isiscat2011 said
Jun 1, 2014
skewedButNotBroken wrote:
I don't have a copy of my latest labs, but I do remember the platelet count was 119 (this has been steadily dropping for years) and the ALT was 162. I would not be surprised if the pathology report was incorrect because as I mentioned on a previous post a while back, 12 years ago, my fibrosis score was F1.
Whatever the case is I'm getting sick and tired of being sick and tired. I'm ready to seek treatment.
High ALT and somewhat low platelets can be indicators of cirrhosis but that is not enough for a definitive diagnosis. You can have clinical and lab indications of cirrhosis with a liver biopsy staging that falls into the category of F3. That may be what your doctor is referring to as "early cirrhosis."
Staging is a tricky thing. If your biopsy was in error you could be at F3, and if your fibrosis progression is unusually rapid it could even be at F4.
Isiscat2011 said
Jun 1, 2014
Hi Testiva:
Cirrhosis is a possibility if the biopsy results were wrong. Sampling errors are not uncommon in liver biopsies and they can be off by 1-2 stages. That is the reason the hepatologist wants to view the slides himself.
He may end up wanting to do his own biopsy or at least a fibroscan. That's my take on the situation.
Something similar happened to me. It is very frightening to go through. Hang in there.
skewedButNotBroken said
Jun 1, 2014
I don't have a copy of my latest labs, but I do remember the platelet count was 119 (this has been steadily dropping for years) and the ALT was 162. I would not be surprised if the pathology report was incorrect because as I mentioned on a previous post a while back, 12 years ago, my fibrosis score was F1.
Whatever the case is I'm getting sick and tired of being sick and tired. I'm ready to seek treatment.
mallani said
Jun 1, 2014
Hi Testiva,
That all sounds a bit odd. Could you ask about the Lab. results, to see what specific items are a worry? If you have a copy, please post your Bilirubin, ALT, ALP, Albumin and platelet count. With a A2 F1 biopsy result only a few months ago, cirrhosis is not a possibility.
skewedButNotBroken said
Jun 1, 2014
I had an appointment with Dr. Paul Martin at the University of Miami Department of Hepatology on the 29th of May. After reviewing my lab work Dr. Martin thinks I might have the beginning stages of cirrhosis. My local doctor in Fort Myers, FL also thought I had cirrhosis based on my lab work. I had a biopsy done in early Feb. of this year and the results were A2 F1. Dr. Martin has requested the slides from the biopsy so that their pathologist can review them. Dr. Martin also ordered a cryoglobulin test.
Now I'm confused, but if my local gastro and a renowned hepatologist thinks my blood work does not correlate with the pathology report for the biopsy then something must be wrong. I know I feel bad most everyday and maybe I do have the early stages of cirrhosis.
I was stage 0 at 2001 by then 2013 cirrhosis had started. guess it just depends on one's self. we are all uniquely different for sure. glad u got to a hepa.. I love mine.. he always gives me thumbs up!! lol that means a whole lot to me. just like the text my granddaughter sent me. I might post what she told me. I had to have a box of Kleenex. lol she is so smart & I love her so much for giving me much needed support.i sure want to be able to see at least one softball game this yr. she is in fast pitch & is very good. already have miss state coach looking at her. she is only 13.. lol makes me & her mom & dad & rest of family very proud. she is not a quitter so I just got to do what she does.. my role model.. <3
Hi Testiva,
Thanks for the reports. They are pretty good and concise. There should be a comment at the start, describing the specimen. It may be called 'Macroscopic', and would say something like 'The specimen consists of 2 cores of tissue measuring 3 cm in length'. It gives a good idea of whether the specimen is adequate.
You do not have cirrhosis, despite any Blood test abnormalities. You are very lucky that your fibrosis progression is slow. I went from F1 to F3-4 in less than 10 years. Despite the fact that biopsy only samples one or two liver segments, it is impossible to have an intact limiting plate in one segment and cirrhosis in another.
Hepatologists like to allow one stage , so you are F2 at worst. You could afford to wait for Sovaldi/Ledipasvir. Best of luck, and let us know the result of the slide review, although it seems pretty clear.
Hi Testiva, thanks for posting your latest biopsy report which indicates that you don`t have cirrhosis. It would be interesting if you could let us know what the pathologist says when he`s examined the slides, and also post any other blood results you get.
Sorry you`re suffering badly from fatigue, that could certainly be a symptom of Hep C and it is possible to feel dreadful even without having cirrhosis. You may well find that once you`ve done treatment you`ll feel a lot better all round.
-- Edited by Cinnamon Girl on Tuesday 3rd of June 2014 11:05:00 AM
Results from 12/09/2002
SURGICAL PATHOLOGY
DIAGNOSIS
1. LIVER BIOPSY:
CHRONIC HEPATITIS C
MILD LOBULAR AND PORTAL HEPATITIS WITH NO HEPATOCELLULAR NECROSIS AND NO LIMITING PLATE NECROSIS
(GRADE I/IV).
NO FIBROSIS OR CIRRHOSIS (STAGE I/IV).
NO INCREASE IN STAINABLE IRON STORIES
THREE LEVELS SHOW LIVER WITH INTACT LOBULAR ARCHITECTURE. CENTRAL VEINS ARE PRESENT AND INTACT. HEPATOCYES ARE ESSENTIALLY UNREMARKABLE. THERE IS NO FATTY CHANGE AND NO HEPATOCELLULAR NECROSIS
#################################################################################
RESULTS FROM 01/03/2014
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
Hi Testiva,
It's important to keep a copy of all your test results.
If you were F1 by biopsy 12 years ago, I doubt whether you'd still be F1, especially as the ALT indicates continuing inflammation. Is it possible to post a copy of the recent biopsy report? Cheers.
High ALT and somewhat low platelets can be indicators of cirrhosis but that is not enough for a definitive diagnosis. You can have clinical and lab indications of cirrhosis with a liver biopsy staging that falls into the category of F3. That may be what your doctor is referring to as "early cirrhosis."
Staging is a tricky thing. If your biopsy was in error you could be at F3, and if your fibrosis progression is unusually rapid it could even be at F4.
Hi Testiva:
Cirrhosis is a possibility if the biopsy results were wrong. Sampling errors are not uncommon in liver biopsies and they can be off by 1-2 stages. That is the reason the hepatologist wants to view the slides himself.
He may end up wanting to do his own biopsy or at least a fibroscan. That's my take on the situation.
Something similar happened to me. It is very frightening to go through. Hang in there.
I don't have a copy of my latest labs, but I do remember the platelet count was 119 (this has been steadily dropping for years) and the ALT was 162. I would not be surprised if the pathology report was incorrect because as I mentioned on a previous post a while back, 12 years ago, my fibrosis score was F1.
Whatever the case is I'm getting sick and tired of being sick and tired. I'm ready to seek treatment.
Hi Testiva,
That all sounds a bit odd. Could you ask about the Lab. results, to see what specific items are a worry? If you have a copy, please post your Bilirubin, ALT, ALP, Albumin and platelet count. With a A2 F1 biopsy result only a few months ago, cirrhosis is not a possibility.
I had an appointment with Dr. Paul Martin at the University of Miami Department of Hepatology on the 29th of May. After reviewing my lab work Dr. Martin thinks I might have the beginning stages of cirrhosis. My local doctor in Fort Myers, FL also thought I had cirrhosis based on my lab work. I had a biopsy done in early Feb. of this year and the results were A2 F1. Dr. Martin has requested the slides from the biopsy so that their pathologist can review them. Dr. Martin also ordered a cryoglobulin test.
Now I'm confused, but if my local gastro and a renowned hepatologist thinks my blood work does not correlate with the pathology report for the biopsy then something must be wrong. I know I feel bad most everyday and maybe I do have the early stages of cirrhosis.
Any comments will be greatly appreciated.
Thanks