WOMENS-HEALTH Messages for September, 1999: Re: enlarged spleen and nodule in liver

Re: enlarged spleen and nodule in liver

From: dr. (anonymous@obgyn.net)
Wed, 29 Sep 1999 20:32:53 -0500 (CDT)

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In reply to: Melissa: "enlarged spleen and nodule in liver"

At Tue, 28 Sep 1999, Melissa wrote: >
>i have been having problems for quite some time now. problems with
>digestion, irregular bleeding (DUB), swollen abdomen, pain-everywhere it
>seems, even my bones seem to hurt. i had a hysterctomy in june because
>i had 30 day cycles and then i'd be off for two or three days and start
>back. now, my problems are even more weird. no one has ever been able
>to tell me what the problem is, they have all just treated the symptoms.
>i have been to eight different doctors. they want to do exploratory
>surgery rather than run tests. anyway, recently my doc found a node or
>maybe a nodule in my liver. he said i may have been born with it, he
>really isn't sure. he told me it could be anything from a cyst to a
>tumor, which really scared me. he also found that my spleen was
>enlarged slightly. he said normal is 12, mine was only 13 point 2. i
>don't know what all this means. the blood tests the other day required
>9 valves of blood. the list of tests the lady printed out of the
>computer struck the floor when she held it up to read it. i'm afraid.
>my next appointment is in two weeks.
>
>questions: how common is a nodule/node in a liver of a 26 year old
>woman? what could cause a spleen to become enlarged? what are the
>dangers these two things?

Dear Melissa,

The maximum cephalocaudad (medical expression which means "from head to tail") diameter of normal spleen is 13 cm. So, your spleen can be considered quite normal. Even if IT IS enlarged, it does NOT always equate with presence of disease. Now about your liver nodule... Well, it could be anything, i.e. liver abscess, cyst, tumor, etc. I don't think that this nodule is something that you've been born with. If it is a liver tumor, then it may be benign or malignant. The differential diagnosis of a benign liver tumor in 26yo woman may include focal nodular hyperplasia and hepatic adenoma. Focal nodular hyperplasia is a benign tumor often identified incidentally on imaging studies or at laparoscopy done for other reasons. Like hepatic adenomas, it occurs predominantly in women; however, oral contraceptives do not appear to be implicated. Unlike hepatic adenoma, surgery is not indicated for focal nodular hyperplasia.

The danger of this nodule, of course, depends on what it actually is. If it's a malignant hepatic tumor (like hepatocellular cancer) or a metastatic cancer (usually from the digestive tract), IT IS dangerous. Something that would relieve your worry (a little bit) is the fact that only 20% - 40% of single hepatic nodule turns out to be hepatocellular cancer, and 5% - 10% of it turns out to be metastatic cancer.

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