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Liver Diseases pp 451–458Cite as

Liver Biopsy for Histopathology

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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.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine 2, Municipal Hospital Düren, Düren, Germany

    Horst Kinkel

  2. Rolf Dammrau Vascular and Thorax Surgery Clinic, Merzenich, Germany

    Francisca Blanca Călinescu

Authors
  1. Horst Kinkel
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  2. Francisca Blanca Călinescu
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Editor information

Editors and Affiliations

  1. Faculty of Medicine, “Titu Maiorescu” University, Central Military Emergency University Hospital “Dr. Carol Davila”, Bucharest, Romania

    Florentina Radu-Ionita

  2. New Jersey Medical School, Rutgers University New Jersey Medical School, Newark, NJ, USA

    Nikolaos T. Pyrsopoulos

  3. Carol Davila University of Medicine and Pharmacy, Central Military Emergency University Hospital “Dr. Carol Davila”, Bucharest, Romania

    Mariana Jinga

  4. Faculty of Medicine, “Titu Maiorescu” University, Central Military Emergency University Hospital “Dr. Carol Davila”, Bucharest, Romania

    Ion C. Tintoiu

  5. Medical Radiation Sciences, Curtin University, Perth, WA, Australia

    Zhonghua Sun

  6. “Prof. C.C. Iliescu” Emergency Institute for Cardiovascular Diseases, Bucharest, Romania

    Ecaterina Bontas

Self Study

Self Study

1.1 Questions

  1. 1.

    When is there an indication for liver puncture?

    1. (a)

      Liver biopsy should be performed to exclude parenchymal damage in every case of elevated liver function tests

    2. (b)

      Biopsy is useful only for chronic liver disease

    3. (c)

      The method of choice is CT-guided hepatic puncture

    4. (d)

      Hepatic puncture is associated with a relatively high risk and should therefore be limited.

    5. (e)

      If hepatic metastases are suspected by an unknown primary tumor, a liver biopsy should be carried out early.

  2. 2.

    Which statement is wrong?

    1. (a)

      Written patient consent should be obtained prior to liver biopsy.

    2. (b)

      The diagnosis of Budd-Chiari syndrome requires a liver biopsy.

    3. (c)

      A liver biopsy can be performed while taking ASA.

    4. (d)

      The most common complication of liver biopsy is pain.

    5. (e)

      In the hands of an experienced examiner, sonographic liver biopsy is a low complication method.

1.2 Answers

  1. 1.

    When is there an indication for liver puncture?

    e. By histological confirmation and, in particular, immunohistochemical support, the pathological finding can in the majority of cases either delimit or definitively differentiate the primary tumor.

  2. 2.

    Which statement is wrong?

    b. Atresia of the large liver veins can be clearly diagnosed by sonography or CT imaging. Liver biopsy is not required.

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Kinkel, H., Călinescu, F.B. (2020). Liver Biopsy for Histopathology. In: Radu-Ionita, F., Pyrsopoulos, N., Jinga, M., Tintoiu, I., Sun, Z., Bontas, E. (eds) Liver Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-24432-3_39

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  • DOI: https://doi.org/10.1007/978-3-030-24432-3_39

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-24431-6

  • Online ISBN: 978-3-030-24432-3

  • eBook Packages: MedicineMedicine (R0)

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