The Variation of Pathological Changes in the Liver Evaluated by Double Biopsies

Abstract

In two simultaneously‐taken needle biopsies of the liver from 70 consecutive patients, a number of changes were evaluated semiquantitatively and compared in n × m tables. The lesions examined were steatosis, Mallory's hyalin, alcoholic hepatitis, cirrhosis and cholestasis; furthermore the size, amount of inflammatory cells, connective tissue and bile‐duct proliferation of the portal tracts and finally focal necroses and acidophilic bodies in the lobules were recorded. Cirrhosis, cholestasis and steatosis showed a high correlation, while the agreement between the two interdependent biopsies, especially concerning acidophilic bodies and bile‐duct proliferation, was low. Possible reasons for the variation in the agreement of the lesions are discussed.

Dual inhibition of epidermal growth factor receptor and insulin‐like growth factor receptor I: Reduction of angiogenesis and tumor growth in cutaneous squamous cell carcinoma

“…Biopsy of the left lateral segment is preferred to limit potential hemorrhagic complications. A single biopsy is performed on the basis of previous investigations which have demonstrated that a single liver biopsy adequately represents the histologic characteristics of the liver as a whole, with the site of biopsy not affecting histology 21–23. Baunsgaard et al21 analyzed core biopsies from left and right lobes in patients with hepatitis and determined no significant pathologic variation among biopsy sites.…”

“…A single biopsy is performed on the basis of previous investigations which have demonstrated that a single liver biopsy adequately represents the histologic characteristics of the liver as a whole, with the site of biopsy not affecting histology 21–23. Baunsgaard et al21 analyzed core biopsies from left and right lobes in patients with hepatitis and determined no significant pathologic variation among biopsy sites. Picciotto et al22 studied left and right lobe biopsies obtained during diagnostic laparoscopy and determined a highly significant histologic correlation for necrosis, steatosis, inflammation, and fibrosis.…”

Histological progression of non‐alcoholic fatty liver disease: a critical reassessment based on liver sampling variability

“…In most, chronic liver diseases, if not all, it has been recognized that the distribution of histological lesions is heterogenous, and therefore the analysis of a single fragment can be misleading 4, 5 . Numerous studies performed in cholestatic, alcoholic or viral liver diseases have confirmed the clinical relevance of sampling variability 5–11 . For example, when two samples were obtained from different parts of the liver in patients with chronic hepatitis C, a discordance of one or more activity grades and/or fibrosis stages could be observed between the two specimens in 20–30% of patients 9, 10 .…”

Nicht invasive Beurteilung des Leberfibrosestadiums mit der transienten Elastografie (FibroScan): Aktueller Stand und Perspektiven

“…Die diagnostische Genauigkeit der Leberbiopsie ist durch Intra-und Inter-Beobachter-Variabilität und Probenfehler eingeschränkt [11 -18]. So haben Studien in 10 -28 % von konsekutiven perkutanen Leberbiopsien einen Unterschied von mindestens einem Fibrosestadium aufgezeigt [17,18] und laparoskopische Studien haben eine Diskrepanz von mindestens einem Fibrosestadium in 33 % der Biopsien aus dem rechten und linken Leberlappen nachgewiesen [14]. In einer Studie von Bedossa et al [11] an über 10 000 virtuellen Leberbiopsien aus 17 Leberresektaten (Unterteilung der Leberresektate unter dem Mikroskop in optische Felder, die von der Fläche der Leberstanzzylinder unterschiedlicher Länge entsprechen) konnte eine korrekte Diagnose des Fibrosestadiums in nur 65 % der Biopsien mit einer Länge von mindestens 15 mm und in 75 % der Biopsien mit einer Länge von mindestens 25 mm gestellt werden.…”