Which enzymes are typically elevated in a space-occupying lesion in the liver?

• A. LD and ALP
• B. AST and ALT
• C. Bilirubin and Ammonia
• D. GGT and 5'NT

Answer: (A)

A space-occupying lesion in the liver tends to cause both local tissue disruption and blockage of bile flow. Alkaline phosphatase is concentrated in the biliary epithelium, so when a lesion compresses or invades bile ducts, ALP rises prominently as a marker of cholestasis and ductular reaction around the tumor. Lactate dehydrogenase is a general cytosolic enzyme released when hepatocytes or surrounding cells are damaged or torn by the lesion, so its level increases with tissue injury caused by the mass.

In this context, the combination of elevated ALP and LD fits the picture of a localized lesion causing both biliary obstruction and cellular damage. Other patterns—such as predominantly AST/ALT elevations from diffuse hepatocellular injury, or bilirubin and ammonia reflecting broad liver failure, or GGT and 5′-nucleotidase signaling cholestasis but not specifically the presence of a discrete lesion—are less characteristic for a space-occupying mass.