<s>[INST] I m a 62 year old female, 5 6 and 150 lbs. I had a recent liver ultrasound and the impression is: Slight coarsening of the hepatic echotexture without intrahepatic biliary ductal dilatation or mass. I was diagnosed with Stage 2, Primary Biliary Cirrhosis about 12 years ago. I m taking Ursodiol and my liver function tests were in the normal range in January. I also have Scleroderma, Sjogrens, Raynauds, GERD and Osteoporosis. I eat a low fat, gluten-free and dairy-free diet, and very rarely have a glass of wine. When researching on-line, it appears the coarsening could be related to fatty liver or cirrhosis. What do the results appear to indicate? [/INST] Hello, As per your history you have already been diagnosed with Primary Biliary Cirrhosis (on unsocial) and a number of other autoimmune disorders (like Progress, Scleroderma etc.). HERD can occur as a result of Scleroderma. PBC is a known cause for chronic liver disease which causes coarse hepatic echo texture on USG.  You would need to monitor the liver function tests including INR levels. I would suggest you to discuss with your gastroenterologist regarding a Transient Hepatic Cartography which can indicate the degree of liver fibrosis and damage.  Hope I have answered your query. Let me know if I can assist you further. Take care  </s>