Significant spleen and liver enlargement
On ultrasound - liver 25.2cm, spleen 17.7cm, portal vein is patent with hepatopetal flow.
On labs - AST - 45, ALT - 70, bilirubin, Alk Phos all normal
I am obese, middle-aged, non-drinker, non-smoker who has had mildly elevated AST/ALT for years. I am actively trying to lose weight, but it is very slow going.
For some reason, when my primary got my ultrasound, she sent me to a cancer clinic. They told me that my liver couldn't be causing such spleen enlargement when my labs aren't showing a high level of liver involvment. They have run a bunch of tests (& are ordering a bone marrow biopsy)) and have also sent me to a gastroenterologist who is also running tests. The gastro dr took one look at me and said it was probably fatty liver - & he disagreed with the cancer people on whether or not the enlargement could be do to severe liver disease with mostly normal labs. I am putting the bone marrow biopsy on hold b/c that seems a bit overkill when other cancer labs seem normal. Gastro is taking a bunch of blood tests. Tried a fibroscan but they couldn't get consistent results b/c of my weight. I don't know what his next thing will be (though I did notice he ordered NASH fibrosure plus, Enhanced liver fibrosis, and fib-4 with reflex to ELF labs).
I'd love to hear your experience if you have had a similar situation. Could my significant spleen enlargement be due to fatty liver that isn't cirrhosis?