What causes a lesion on liver ultrasound scan

Dear Ask The Doctor: I did an ultrasound scan on my liver and found two lesions (about 1+ cm each). My doctor said they are inconclusive what they are and suggested I do a CT scan, which I've agreed. I'm waiting for my appointment date but I'm worried. The reason I did the ultra sound is my ALT and AST are high. ALT = 104. AST = 45. My ALT has been high for 5 years, started from a reading of 65 5 years ago to 104 recently. Can someone advise on what really does a lesion mean? My doctor said I have a fatty liver. The lesion could be nothing more than a patch on my liver without fat or the worst case can be tumor. This freaks me out. Appreciate any further help on this.

Dear M C: It is impossible to know at this stage what the lesions on your liver represent that were visualized on ultrasound sound scan. Lesions smaller than approximately 1.0 cm are commonly benign incidental findings on imaging studies, and in most cases represent small cysts, hemangiomas (benign growth of cells that line blood vessels) or biliary hamartomas (benign tumour-like malformation of the liver). They are often difficult to definitively characterize by imaging methods due to their small size, and due to their small size it is difficult to sample the tissue by biopsy. Often clinical follow-up is the only option for these lesions. The abnormal liver function tests could be explained by fatty liver disease. CT scan should provide more information about these lesions, and whether any treatment or follow-up will be necessary.