Tranjugular liver biopsy: how good is it for accurate histological interpretation?

Cholongitas, E.; Quaglia, A.; Samonakis, D.; Senzolo, M.; Triantos, C.; Patch, D.; Leandro, G.; Dhillon, A. P.; Burroughs, A. K.
December 2006
Gut;Dec2006, Vol. 55 Issue 12, p1789
Academic Journal
Background: A transjugular liver biopsy (TJLB) specimen is often smaller or more fragmented than a percutaneous liver biopsy (PIB) specimen, Recently, for PLB, the minimum requirements to evaluate chronic hepatitis have been set at 20-25 mm length and ⩾ 11 complete portal tracts. Aim: To evaluate and compare length of TJLB and PIB specimens, portal tract number, fragmentation and adequacy for histopathological diagnosis and staging. Patients and methods: 326 consecutive TJLB specimens in 274 patients (109 who had undergone a transplantation), always using three passes (19-G Tru-cut) and 40 consecutive PIB specimens (15-G Menghini). Results: No technical failures occurred with the TJLB, and histological diagnosis was possible in 98.5%. The median (range) number of fragments was 5 (1-13) and the median total length was 22 (3-46) mm, with 65% of specimens ⩾20 mm and 36% ⩾⩾25 mm; 60% of TJLB specimens were ⩾28 mm long had ⩾ 11 complete portal tracts. No difference in complete portal tract number or biopsy length was found between PLB and TJLB specimens. Conclusion: A TJLB specimen with three passes is adequate for histological diagnosis, with 89% of specimens being either ⩾ 15 mm or having ⩾6 complete portal tracts. Although adequate sampling remains a limitation for staging and grading of chronic hepatitis, TJLB is comparable to PLB in this respect.


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