Does an enlarged liver necessarily mean liver cancer?

An enlarged liver is a common sign of liver cancer. The characteristics of an enlarged liver caused by liver cancer are that the liver surface is not smooth but nodular, the liver has regular edges, and the texture is as hard as stone. If an ultrasound or CT scan is performed, typical cancer nodules can be found in the liver. However, there are many reasons for an enlarged liver, and not all of them are caused by liver cancer.

In addition to liver tumors, the common cause of liver enlargement is viral hepatitis. The liver of patients with viral hepatitis is usually full, smooth, and relatively soft. It may be painful to touch the liver. Liver function tests showed that alanine aminotransferase and aspartate aminotransferase were significantly elevated, alpha-fetoprotein in the blood was negative, and ultrasound and CT examinations did not find liver tumors. If antiviral treatment and liver protection treatment are given, the inflammation of the liver will improve and the enlarged liver will shrink.

Another common cause is congestive cirrhosis, in which the liver is obviously enlarged. The main cause is right heart dysfunction, or due to hepatic vein or inferior vena cava thrombosis, which causes hepatic venous blood return obstruction and causes congestive enlargement of the liver. Liver enlargement caused by right heart failure is manifested as a full liver and regular liver edges. If an ultrasound or CT scan is performed, the texture of the liver is uniform and there are no space-occupying lesions. Right heart dysfunction often has symptoms and signs of heart failure. Hepatic vein or inferior vena cava thrombosis can be detected through ultrasound, CT and other imaging examinations to detect blood flow abnormalities and the cause of embolism, which is not difficult to identify.

Other causes of liver enlargement include immune and metabolic diseases, such as hemochromatosis and hepatic amyloidosis. These lesions have their own characteristic clinical manifestations and can be diagnosed through liver puncture biopsy.