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Liver Diseases pp 451-458 | Cite as

Liver Biopsy for Histopathology

  • Horst Kinkel
  • Francisca Blanca Călinescu
Chapter

Abstract

Due to technological advancements and the widespread use of diagnostic imaging modalities in current clinical practice focal liver lesions are increasingly being discovered. Differentiation of these lesions is considered to be critical for determining treatment options. In this regard, histological assessment of the liver, liver biopsy remains a cornerstone in the evaluation and management of patients with liver disease. Despite that sensitive and relatively accurate blood tests used to detect and diagnose liver disease have now become widely available, liver biopsy will remain a valuable diagnostic tool. It has currently three major roles: (1) diagnosis, (2) assessment of prognosis (disease staging), and/or (3) to assist in making therapeutic management decisions.

Several techniques may be used to obtain liver tissue. These include a percutaneous method, a transvenous (transjugular or transfemoral), an endoscopic (transgastric) approach as well as intra-abdominal biopsy (laparoscopic or laparotomic). While in case of percutaneous approach ultrasound guidance is the favored modality, computed tomography (CT), magnetic resonance (MR) and fusion imaging techniques have all been used.

In the present chapter we summarize the current practice of liver biopsy with an emphasis on the indications, contraindications, technique and risk of complications.

Keywords

Liver biopsy Percutaneous liver biopsy Histopathology Ultrasound-assisted liver biopsy 

References

  1. 1.
    Taltavull TC. Rethinking the role of liver biopsy in the era of personalized medicine. In: Tagaya N, editor. Liver biopsy. Rijeka: IntechOpen; 2012.  https://doi.org/10.5772/53120. Available from: https://www.intechopen.com/books/liver-biopsy-indications-procedures-results/rethinking-the-role-of-liver-biopsy-in-the-era-of-personalized-medicine.CrossRefGoogle Scholar
  2. 2.
    Dahiya N, Middleton WD, Menias CO. Ultrasound-guided visceral biopsies: renal and hepatic. Ultrasound Clin. 2012;7:363–75.CrossRefGoogle Scholar
  3. 3.
    Schüpfer F. De la possibilite de faire “intra vitam” un diagnostic histo-pathologique precis des maladies due foie et de la rate. Sem Med. 1907;27:229.Google Scholar
  4. 4.
    Randazzo C, Licata A, Almasio PL. Liver biopsy - indications, procedures, results. In: Tagaya N, editor. Liver biopsy. Rijeka: IntechOpen; 2012.  https://doi.org/10.5772/52616. Available from: https://www.intechopen.com/books/liver-biopsy-indications-procedures-results/liver-biopsy-indications-procedures-results.CrossRefGoogle Scholar
  5. 5.
    Cadranel J-F, Nousbaum J-B. Current trends in liver biopsy indications for chronic liver diseases. In: Tagaya N, editor. Liver biopsy. Rijeka: IntechOpen; 2012.  https://doi.org/10.5772/52618. Available from: https://www.intechopen.com/books/liver-biopsy-indications-procedures-results/current-trends-in-liver-biopsy-indications-for-chronic-liver-diseases.CrossRefGoogle Scholar
  6. 6.
    Strobel D, et al. Contrast-enhanced ultrasound fort the characterisation of focal liver lesions – diagnostic accuracy in clinical practice (DEGUM multicenter trial). Eur J Ultrasound. 2008;59:499–505.Google Scholar
  7. 7.
    Nufer M, Stuckmann G, Decurtins M. Benigne Tumoren der Leber: Diagnostik und Therapie – eine Übersicht. Schweiz Med Wochenschr. 1999;129:1257–64.PubMedGoogle Scholar
  8. 8.
    Schirmacher P, Longerich T. Hochdifferenzierte Lebertumore Neue Entwicklungen und ihre diagnostische Relevanz. Pathologe. 2009;30(Suppl 2):200–6.CrossRefGoogle Scholar
  9. 9.
    Khan SA, et al. Guidelines for the diagnosis and treatment of cholangiocarcinoma: consensus document. Gut. 2002;51(Suppl VI):vi1–9.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Anderson CD, Pinson CW, Berlin J, Chari RS. Diagnosis and treatment of cholangiocarcinoma. Oncologist. 2004;9:43–57.CrossRefGoogle Scholar
  11. 11.
    Caselmann WH, et al. Leitlinie der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten zur Diagnostik und Therapie des hepatozellulären Karzinoms. Z Gastroenterol. 1999;37:353–65.PubMedGoogle Scholar
  12. 12.
    Bruix J, Sherman M. AASLD practice guideline: management of hepatocellular carcinoma. Hepatology. 2005;42:1208–36.CrossRefGoogle Scholar
  13. 13.
    Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. AASLD position paper: Liver biopsy. Hepatology. 2009;49:1017–44.CrossRefGoogle Scholar
  14. 14.
    Huang JY. Role of EUS-guided liver biopsy in benign parenchymal disease (with video). Endosc Ultrasound. 2018;7(4):236–9.CrossRefGoogle Scholar
  15. 15.
    Vijayaraghavan GR, David S, Bermudez-Allende M, Sarwat H. Imaging-guided parenchymal liver biopsy: how we do it. J Clin Imaging Sci. 2011;1(2):30.CrossRefGoogle Scholar
  16. 16.
    Colloredo G, Guido M, Sonzogni A, Leandro G. Impact of liver biopsy size on histological evaluation of chronic viral hepatitis: the smaller the sample, the milder the disease. J Hepatol. 2003;39:239–44.CrossRefGoogle Scholar
  17. 17.
    Crawford AR, Lin XZ, Crawford JM. The normal adult human liver biopsy: a quantitative reference standard. Hepatology. 1998;28:323–31.CrossRefGoogle Scholar
  18. 18.
    Park HJ, et al. Fusion imaging-guided percutaneous biopsy of focal hepatic lesions with poor conspicuity on conventional sonography. J Ultrasound Med. 2013;32:1557–64.CrossRefGoogle Scholar
  19. 19.
    Ewersten C, et al. Real-time image fusion involving diagnostic ultrasound. AJR. 2013;200:249–55.CrossRefGoogle Scholar
  20. 20.
    Lee MW. Fusion imaging of real-time ultrasonography with CT or MRI for hepatic intervention. Ultrasonography. 2014;33(4):227–39.CrossRefGoogle Scholar
  21. 21.
    Tagaya N, Makino N, Saito K, Okuyama T, Sugamata Y, Oya M. Types of liver biopsy. In: Tagaya N, editor. Liver biopsy. Rijeka: IntechOpen; 2012.  https://doi.org/10.5772/52914. Available from: https://www.intechopen.com/books/liver-biopsy-indications-procedures-results/types-of-liver-biopsy.CrossRefGoogle Scholar
  22. 22.
    Meng HC, et al. Transjugular liver biopsy: comparison with percutaneous liver biopsy. J Gastroenterol Hepatol. 1994;9(5):457–61.CrossRefGoogle Scholar
  23. 23.
    Keshava SN, et al. Transjugular liver biopsy: what to do and what not to do. Indian J Radiol Imaging. 2008;18:245–8.CrossRefGoogle Scholar
  24. 24.
    Bravo AA, Sheth SG, Chopra S. Liver biopsy. N Engl J Med. 2001;344:495–500.CrossRefGoogle Scholar
  25. 25.
    Zaman A, Ingram K, Flora KD. Diagnostic liver biopsy. Available from: http://emedicine.medscape.com. Last updated on 18 Nov 2009.
  26. 26.
    Alswat KA, Mumtaz K, Jafri W. Liver biopsy for histological assessment: the case in favor. Saudi J Gastroenterol. 2010;16(2):133–9.CrossRefGoogle Scholar
  27. 27.
    Strobel D, et al. Incidence of bleeding in 8172 percutaneous ultrasound-guided intraabdominal diagnostic and therapeutic interventions - results of the prospective multicenter DEGUM interventional ultrasound study (PIUS Study). Ultraschall Med. 2015;36:122–31.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Horst Kinkel
    • 1
  • Francisca Blanca Călinescu
    • 2
  1. 1.Department of Internal Medicine 2Municipal Hospital DürenDürenGermany
  2. 2.Rolf Dammrau Vascular and Thorax Surgery ClinicMerzenichGermany

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