![]() In either case, the fragmentation may interfere with visualization of key histologic features. Some liver biopsies may be fragmented when submitted for evaluation, either due to biopsy technique or due to the nature of the lesion (e.g., cirrhosis). Generally, most liver biopsies are 1-2 cm in length however, studies have shown that biopsies at least 1.5 cm to 2.5 cm in length allow for better interpretation. Although there are no formal “requirements” for evaluation of adequacy, it is usually assessed based upon the length of the core biopsy, biopsy fragmentation, and the number of portal tracts. One of the first things to evaluate on a liver biopsy is whether the specimen is adequate. Once the biopsy has been assessed and a differential diagnosis formulated, then the microscopic findings can be correlated to the clinical history. Many pathologists first assess the liver biopsy without a clinical history so as to not bias the true interpretation. Types of liver biopsy (A) core needle biopsy (B) wedge biopsy. It is important to note that although there is more tissue available to assess, these biopsies are often subcapsular, which may give the false impression of increased fibrosis.įigure 1. Wedge biopsies (Figure 1B) provide larger samples of tissue for pathologic interpretation. Image-guided biopsy may be performed to target a specific lesion seen on imaging or when the other biopsy approaches have failed. Laparoscopic or open biopsies are taken when the patient is already undergoing surgery for another reason. Transjugular biopsy is used in patients with a history of coagulopathy, significant ascites, or morbid obesity. Percutaneous biopsy is the most common method. There are several approaches that may be used to obtain a core needle biopsy, including percutaneous, transjugular, laparoscopic or open, and image-guided. Patients can have two types of liver biopsies: core needle biopsies or wedge biopsies.Ĭore needle biopsies (Figure 1A ) generate long cylindrical cores of liver parenchyma ~ 1 to 2 cm in length by ~ 0.2 cm in width. What type of liver biopsies do patients get? ![]() The main goals of a liver biopsy are to (1) render a diagnosis in a patient with abnormal liver function tests (LFTs) or a liver lesion on imaging, (2) provide staging and grading in a patient with a history of chronic hepatitis, (3) assess the liver’s response to treatment, and (4) assess the function of a liver transplant.
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