Guest guest Posted May 20, 2008 Report Share Posted May 20, 2008 Thank you ! wrote: Liver Biopsy Liver biopsy is not necessary for diagnosis but is helpful for grading the severity of disease and staging the degree of fibrosis and permanent architectural damage. Hematoxylin and eosin stains and Masson's trichrome stain are used to grade the amount of necrosis and inflammation and to stage the degree of fibrosis. Specific immunohistochemical stains for HCV have not been developed for routine use. Liver biopsy is also helpful in ruling out other causes of liver disease, such as alcoholic liver injury or iron overload. HCV causes the following changes in liver tissue: •Necrosis and inflammation around the portal areas, so-called "piecemealnecrosis" or "interface hepatitis." •Necrosis of hepatocytes and focal inflammation in the liver parenchyma. •Inflammatory cells in the portal areas ("portal inflammation"). •Fibrosis, with early stages being confined to the portal tracts, intermediate stages being expansion of the portal tracts and bridging between portal areas or to the central area, and late stages being frank cirrhosis characterized by architectural disruption of the liver with fibrosis and regeneration. Grading and Staging of hepatitis by assigning scores for severity are helpful in managing patients with chronic hepatitis. The degree of inflammation and necrosis can be assessed as none, minimal, mild, moderate, or severe. The degree of fibrosis can be similarly assessed. Scoring systems are particularly helpful in clinical studies on chronic hepatitis. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2008 Report Share Posted May 20, 2008 The article I posted after this one goes more into details about the staging and grading .. Glad I could help ya Re: Liver Biopsy Thank you ! <elizabethnv1earthlink (DOT) net> wrote: Liver Biopsy Liver biopsy is not necessary for diagnosis but is helpful for grading the severity of disease and staging the degree of fibrosis and permanent architectural damage. Hematoxylin and eosin stains and Masson's trichrome stain are used to grade the amount of necrosis and inflammation and to stage the degree of fibrosis. Specific immunohistochemical stains for HCV have not been developed for routine use. Liver biopsy is also helpful in ruling out other causes of liver disease, such as alcoholic liver injury or iron overload. HCV causes the following changes in liver tissue: •Necrosis and inflammation around the portal areas, so-called "piecemealnecrosis" or "interface hepatitis." •Necrosis of hepatocytes and focal inflammation in the liver parenchyma. •Inflammatory cells in the portal areas ("portal inflammation"). •Fibrosis, with early stages being confined to the portal tracts, intermediate stages being expansion of the portal tracts and bridging between portal areas or to the central area, and late stages being frank cirrhosis characterized by architectural disruption of the liver with fibrosis and regeneration. Grading and Staging of hepatitis by assigning scores for severity are helpful in managing patients with chronic hepatitis. The degree of inflammation and necrosis can be assessed as none, minimal, mild, moderate, or severe. The degree of fibrosis can be similarly assessed. Scoring systems are particularly helpful in clinical studies on chronic hepatitis. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2008 Report Share Posted May 20, 2008 It is so great to be a part of this group..... again, Thank you.elizabethnv1 wrote: The article I posted after this one goes more into details about the staging and grading .. Glad I could help ya Re: Liver Biopsy Thank you ! <elizabethnv1earthlink (DOT) net> wrote: Liver Biopsy Liver biopsy is not necessary for diagnosis but is helpful for grading the severity of disease and staging the degree of fibrosis and permanent architectural damage. Hematoxylin and eosin stains and Masson's trichrome stain are used to grade the amount of necrosis and inflammation and to stage the degree of fibrosis. Specific immunohistochemical stains for HCV have not been developed for routine use. Liver biopsy is also helpful in ruling out other causes of liver disease, such as alcoholic liver injury or iron overload. HCV causes the following changes in liver tissue: •Necrosis and inflammation around the portal areas, so-called "piecemealnecrosis" or "interface hepatitis." •Necrosis of hepatocytes and focal inflammation in the liver parenchyma. •Inflammatory cells in the portal areas ("portal inflammation"). •Fibrosis, with early stages being confined to the portal tracts, intermediate stages being expansion of the portal tracts and bridging between portal areas or to the central area, and late stages being frank cirrhosis characterized by architectural disruption of the liver with fibrosis and regeneration. Grading and Staging of hepatitis by assigning scores for severity are helpful in managing patients with chronic hepatitis. The degree of inflammation and necrosis can be assessed as none, minimal, mild, moderate, or severe. The degree of fibrosis can be similarly assessed. Scoring systems are particularly helpful in clinical studies on chronic hepatitis. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2008 Report Share Posted May 20, 2008 No problem , that is the whole reason for this group .. Re: Liver Biopsy It is so great to be a part of this group..... again, Thank you.elizabethnv1 <elizabethnv1earthlink (DOT) net> wrote: The article I posted after this one goes more into details about the staging and grading .. Glad I could help ya ----- Original Message ----- .. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 30, 2008 Report Share Posted May 30, 2008 My gastroenterologist will NOT order a liver biopsy. He doesn't think it's indicated " at this time " . He's ordered ultrasound (which showed a liver 'more nodular than we expected'), ordered endoscopy (to check for bleeding varices), and says that if a study I'm eligible for requires a liver biopsy, he'll do one. I'm being treated at the Kirklin Clinic in Birmingham, and UAB is supposed to know livers, but I worry. Especially since my liver is 'more nodular', I want to know what's going on. Is a liver biopsy such a bad thing? Roy in Alabama > > > Liver Biopsy > > > > Liver biopsy is not necessary for diagnosis but is helpful for grading > the severity of disease and staging the degree of fibrosis and permanent > architectural damage. Hematoxylin and eosin stains and Masson's > trichrome stain are used to grade the amount of necrosis and > inflammation and to stage the degree of fibrosis. Specific > immunohistochemical stains for HCV have not been developed for routine > use. Liver biopsy is also helpful in ruling out other causes of liver > disease, such as alcoholic liver injury or iron overload. HCV causes the > following changes in liver tissue: > > •Necrosis and inflammation around the portal areas, so-called > " piecemealnecrosis " or " interface hepatitis. " > > •Necrosis of hepatocytes and focal inflammation in the liver > parenchyma. > > •Inflammatory cells in the portal areas ( " portal inflammation " ). > > •Fibrosis, with early stages being confined to the portal tracts, > intermediate stages being expansion of the portal tracts and bridging > between portal areas or to the central area, and late stages being frank > cirrhosis characterized by architectural disruption of the liver with > fibrosis and regeneration. > > Grading and Staging of hepatitis by assigning scores for severity are > helpful in managing patients with chronic hepatitis. The degree of > inflammation and necrosis can be assessed as none, minimal, mild, > moderate, or severe. The degree of fibrosis can be similarly assessed. > Scoring systems are particularly helpful in clinical studies on chronic > hepatitis. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 Be sure to ask Your doctor/s about the Fibrosure liver test, it's 'supposed-to-be' accurate as far as sensing the level/s of liver- damage. Here's a Google-Search URL about the Fibrosure test. http://tinyurl.com/449zna As far as a Liver-Biopsy goes, I had no problem with mine. Just around 3-4 hours recovery time, and they send one home,....as long as there aren't any complications. Here is a Needle Biopsy Video, it's 'pretty-much' how mine went as well. Video of a 'typical' Needle Biopsy of the Liver http://www.tinyurl.com/2daof7 > > > > > > Liver Biopsy > > > > > > > > Liver biopsy is not necessary for diagnosis but is helpful for > grading > > the severity of disease and staging the degree of fibrosis and > permanent > > architectural damage. Hematoxylin and eosin stains and Masson's > > trichrome stain are used to grade the amount of necrosis and > > inflammation and to stage the degree of fibrosis. Specific > > immunohistochemical stains for HCV have not been developed for > routine > > use. Liver biopsy is also helpful in ruling out other causes of > liver > > disease, such as alcoholic liver injury or iron overload. HCV > causes the > > following changes in liver tissue: > > > > •Necrosis and inflammation around the portal areas, so-called > > " piecemealnecrosis " or " interface hepatitis. " > > > > •Necrosis of hepatocytes and focal inflammation in the liver > > parenchyma. > > > > •Inflammatory cells in the portal areas ( " portal inflammation " ). > > > > •Fibrosis, with early stages being confined to the portal tracts, > > intermediate stages being expansion of the portal tracts and > bridging > > between portal areas or to the central area, and late stages being > frank > > cirrhosis characterized by architectural disruption of the liver > with > > fibrosis and regeneration. > > > > Grading and Staging of hepatitis by assigning scores for severity > are > > helpful in managing patients with chronic hepatitis. The degree of > > inflammation and necrosis can be assessed as none, minimal, mild, > > moderate, or severe. The degree of fibrosis can be similarly > assessed. > > Scoring systems are particularly helpful in clinical studies on > chronic > > hepatitis. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 Hi Roy, I have been going to the Mayo Clinic in ville, Florida for 6 months now. I have had every test imaginable except a liver biopsy. With a serum Ferritin blood test you could tell I had Iron over load but the Mayo Doctors say that's normal and phlebotomy's don't work to correct it. Personally I think there is some liability issues but oh well I am kinda at the mercy of these Doctors My Doctor said he did not want to remove the iron because it will reduce my WBC count and he wants me to start treatment in September. When I asked why no liver biopsy he said from the 2 weeks of tests they ran they got all the information they need and a biopsy IS dangerous. Anytime they do invasive surgery there are risks especially if you are End Stage like me. His only concern was my mental state....I kind went a little crazy when I was told I was dying and needed a liver transplant Thanks to Celexa I am doing much much better! My Psychiatrist agrees so I began TX in September and man am I scared! So I guess it depends on allot of thing why some would request a biopsy. I have been told by more than one person biopsy's are old news and a unnecessary risk. But taking interferon and ribivir is not??? I gave up trying to make sense of this disease and just go with the flow altho I do research and ask allot of questions which they happily answer for me in a VERY condencending way. Like how dare a lay person like you question me Ack I hate traditional medicine but its all I got that works. So I guess the point of my long winded post is get on some anti depressants, question what they tell you and research it AND most important don't worry about stuff until your told you need it done or you'll end up crazy as a bed bug like I did 53 years old, diagnosed in December 2007, with End Stage liver disease Geno 3 with a low viral load of 255,000. Heart, lungs, pancreas, colon, stomach, kidneys all in excellent shape. Everything else is junk Decompensated Cirrhosis, Esophageal varices, portal hypertension, encephalopathy, periumbilical hernia, ascites, edema and just a little non obstructive calculus in a kidney. Tired all the time, peeing my brains out and lost allot of muscle due to muscle wasting. Geez cannot wait for liver transplant!!!!! > Re: Liver Biopsy > > > My gastroenterologist will NOT order a liver biopsy. He doesn't think > it's indicated " at this time " . He's ordered ultrasound (which showed > a liver 'more nodular than we expected'), ordered endoscopy (to check > for bleeding varices), and says that if a study I'm eligible for > requires a liver biopsy, he'll do one. > > I'm being treated at the Kirklin Clinic in Birmingham, and UAB is > supposed to know livers, but I worry. Especially since my liver > is 'more nodular', I want to know what's going on. Is a liver biopsy > such a bad thing? > > Roy in Alabama > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 Hi, ! You're going to one of the top tp hcv centers in the world. I think you have to give their Docs more credit. Always good to have and ask questions, but I haven't had a biopsy in a few years, yet I'm about to get on the tp list at Lifelink of Tampa. I live in Fort Myers, otherwise I too would go to the the Mayo in Jax. See my Post above. I also had high iron content a few years ago, and the Docs wouldn't give me anything. They simply said to watch my diet a liquids. My iron levels have gone way down to normal. Looks like we're in the same boat, my friend! And don't be scared of the tx. It'll help prolong your liver for a better chance a tp. You must keep your physical and mental states in line. The Celexa also works well for me. This whole trip is a roller coaster ride. Highs and lows, thrills and fright. However, the coaster always ends where you got on! (If that doesn't make sense, blame my hepper brain, lol!). > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 Hi Rick thanks for the encouraging words {{{{HUGS}}} to you and good luck with your TP. I am only a MELD 11 so not on the list yet but with the crap care I seem to be getting I'll probably get there soon. Oh don't you just LOVE the brain fog Getting worse every month and I am now up to a 77 ammonia level which is still not that bad but I am so terrified about when it does get up into the 200 range what that will be like. Will I be a drooling vegetable laying in bed all day What Geno type are you and did you achieve SVR with treatment? Do you have the ascites and edema? From what I keep reading its like a REAL long shot that it will work with a decompensated liver and all the medication I am on now and according to the Mayo I could possibly die or end up on the transplant list real quick. My hepatologist words were " It is not going to be a cake walk " The only reason I agreed to it was because I was a Geno 3a with a very very low viral load and I can quit whenever I want to. > > Hi, ! You're going to one of the top tp hcv centers in the > world. I think you have to give their Docs more credit. Always good > to have and ask questions, but I haven't had a biopsy in a few years, > yet I'm about to get on the tp list at Lifelink of Tampa. I live in > Fort Myers, otherwise I too would go to the the Mayo in Jax. See my > Post above. I also had high iron content a few years ago, and the > Docs wouldn't give me anything. They simply said to watch my diet a > liquids. My iron levels have gone way down to normal. Looks like > we're in the same boat, my friend! And don't be scared of the tx. > It'll help prolong your liver for a better chance a tp. You must keep > your physical and mental states in line. The Celexa also works well > for me. This whole trip is a roller coaster ride. Highs and lows, > thrills and fright. However, the coaster always ends where you got > on! (If that doesn't make sense, blame my hepper brain, lol!). > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 There seems to be some variance in the thinking about the accuracy of the Fibrosure test regarding the detection of intermediate stages as of yet. Don't ask ME,...I don't know, but here is a Google Search for: + " fibrosure " + " intermediate stages " http://tinyurl.com/435x2m > > > > > > > > > Liver Biopsy > > > > > > > > > > > > Liver biopsy is not necessary for diagnosis but is helpful for > > grading > > > the severity of disease and staging the degree of fibrosis and > > permanent > > > architectural damage. Hematoxylin and eosin stains and Masson's > > > trichrome stain are used to grade the amount of necrosis and > > > inflammation and to stage the degree of fibrosis. Specific > > > immunohistochemical stains for HCV have not been developed for > > routine > > > use. Liver biopsy is also helpful in ruling out other causes of > > liver > > > disease, such as alcoholic liver injury or iron overload. HCV > > causes the > > > following changes in liver tissue: > > > > > > .Necrosis and inflammation around the portal areas, so-called > > > " piecemealnecrosis " or " interface hepatitis. " > > > > > > .Necrosis of hepatocytes and focal inflammation in the liver > > > parenchyma. > > > > > > .Inflammatory cells in the portal areas ( " portal inflammation " ). > > > > > > .Fibrosis, with early stages being confined to the portal tracts, > > > intermediate stages being expansion of the portal tracts and > > bridging > > > between portal areas or to the central area, and late stages > being > > frank > > > cirrhosis characterized by architectural disruption of the liver > > with > > > fibrosis and regeneration. > > > > > > Grading and Staging of hepatitis by assigning scores for > severity > > are > > > helpful in managing patients with chronic hepatitis. The degree of > > > inflammation and necrosis can be assessed as none, minimal, mild, > > > moderate, or severe. The degree of fibrosis can be similarly > > assessed. > > > Scoring systems are particularly helpful in clinical studies on > > chronic > > > hepatitis. > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 4, 2008 Report Share Posted June 4, 2008 I just found out today from my dr that the transjugular biopsy does not go thru the heart. It goes from the jugular into the hepatic vein and into the liver. This form of biopsy is used mostly for people with low platlet counts or who are facing the first part of rejection after transplant or who are in rejection. It gives a clearer view of exacally what is happening in the liver. The biopsy from the side or thru the ribs causes excessive bleeding and is no longer recommended for people in rejection or with low platlet counts. Ask your dr if this could be an alternative for you. Steve B... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 4, 2008 Report Share Posted June 4, 2008 That is the type of biopsy i had. I was awake but remember nothing. No pain. And it was because of my low platlets and clotting time. Just a bandaid on the neck. Debbie > > I just found out today from my dr that the transjugular biopsy does not go thru the heart. It goes from the jugular into the hepatic vein and into the liver. This form of biopsy is used mostly for people with low platlet counts or who are facing the first part of rejection after transplant or who are in rejection. It gives a clearer view of exacally what is happening in the liver. The biopsy from the side or thru the ribs causes excessive bleeding and is no longer recommended for people in rejection or with low platlet counts. Ask your dr if this could be an alternative for you. > Steve B... > Quote Link to comment Share on other sites More sharing options...
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