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==Overview== | ==Overview== | ||
Liver biopsy is the gold standard test for the diagnosis of liver mass. Common indications for biopsy in liver mass include suspected hepatocellular carcinoma, and unspecific imaging findings. The most important contraindication for biopsy in liver mass is suspected liver hemangioma.<ref name="libre">Hepatocellular carcinoma. Libre Pathology.https://librepathology.org/wiki/Hepatocellular_carcinoma Accessed on March 28, 2016 </ref><ref name="pmid8201212">{{cite journal |vauthors=Borzio M, Borzio F, Macchi R, Croce AM, Bruno S, Ferrari A, Servida E |title=The evaluation of fine-needle procedures for the diagnosis of focal liver lesions in cirrhosis |journal=J. Hepatol. |volume=20 |issue=1 |pages=117–21 |year=1994 |pmid=8201212 |doi= |url=}}</ref> | Liver biopsy is the gold standard test for the diagnosis of liver mass. Common indications for biopsy in liver mass include suspected [[hepatocellular carcinoma]], and unspecific imaging findings. The most important contraindication for biopsy in liver mass is suspected liver [[hemangioma]].<ref name="libre">Hepatocellular carcinoma. Libre Pathology.https://librepathology.org/wiki/Hepatocellular_carcinoma Accessed on March 28, 2016 </ref><ref name="pmid8201212">{{cite journal |vauthors=Borzio M, Borzio F, Macchi R, Croce AM, Bruno S, Ferrari A, Servida E |title=The evaluation of fine-needle procedures for the diagnosis of focal liver lesions in cirrhosis |journal=J. Hepatol. |volume=20 |issue=1 |pages=117–21 |year=1994 |pmid=8201212 |doi= |url=}}</ref> | ||
==Biopsy== | ==Biopsy== | ||
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=== Contraindications === | === Contraindications === | ||
*Contraindications for biopsy in liver mass, include:<ref name="pmid8201212">{{cite journal |vauthors=Borzio M, Borzio F, Macchi R, Croce AM, Bruno S, Ferrari A, Servida E |title=The evaluation of fine-needle procedures for the diagnosis of focal liver lesions in cirrhosis |journal=J. Hepatol. |volume=20 |issue=1 |pages=117–21 |year=1994 |pmid=8201212 |doi= |url=}}</ref> | *Contraindications for biopsy in liver mass, include:<ref name="pmid8201212">{{cite journal |vauthors=Borzio M, Borzio F, Macchi R, Croce AM, Bruno S, Ferrari A, Servida E |title=The evaluation of fine-needle procedures for the diagnosis of focal liver lesions in cirrhosis |journal=J. Hepatol. |volume=20 |issue=1 |pages=117–21 |year=1994 |pmid=8201212 |doi= |url=}}</ref> | ||
**Suspected hemangioma | **Suspected [[hemangioma]] | ||
**Adenomas | **Adenomas | ||
**Patients on of anticoagulant therapy | **Patients on of [[anticoagulant]] therapy | ||
**Unstable medical conditions ( | **Unstable medical conditions (e.g. [[Congestive heart failure|acute heart failure]]) | ||
=== Complications === | === Complications === | ||
Revision as of 21:06, 15 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
Liver biopsy is the gold standard test for the diagnosis of liver mass. Common indications for biopsy in liver mass include suspected hepatocellular carcinoma, and unspecific imaging findings. The most important contraindication for biopsy in liver mass is suspected liver hemangioma.[1][2]
Biopsy
Biopsy is always indicated in patients presenting with liver mass to rule out malignancy. Biopsy findings associated with liver mass will depend on tumor histology. [2]
Indications
- Indications for biopsy in liver mass, include:
- Suspected hepatocellular carcinoma[2]
- Unspecific and inconclusive liver mass imaging findings
Types
- Per-cutaneous, ultrasound-guided liver biopsy
- Laparoscopic liver biopsy
- Transjugular liver biopsy
| DIsease | Findings on Biopsy |
|---|---|
| Focal nodular hyperplasia | Ductular reaction with varied intensity at the junction of the fibrous septa with the hepatocellular component, |
| Hepato-cellular carcinoma | Two out of the following three positive stains upon liver biopsy confirm HCC:[3][4] |
| Cirrhosis |
|
Contraindications
- Contraindications for biopsy in liver mass, include:[2]
- Suspected hemangioma
- Adenomas
- Patients on of anticoagulant therapy
- Unstable medical conditions (e.g. acute heart failure)
Complications
Complications for for biopsy in liver mass, include:[2]
- Bleeding
- Seeding of neoplastic cell
References
- ↑ Hepatocellular carcinoma. Libre Pathology.https://librepathology.org/wiki/Hepatocellular_carcinoma Accessed on March 28, 2016
- ↑ 2.0 2.1 2.2 2.3 2.4 Borzio M, Borzio F, Macchi R, Croce AM, Bruno S, Ferrari A, Servida E (1994). "The evaluation of fine-needle procedures for the diagnosis of focal liver lesions in cirrhosis". J. Hepatol. 20 (1): 117–21. PMID 8201212.
- ↑ "Pathologic diagnosis of early hepatocellular carcinoma: a report of the international consensus group for hepatocellular neoplasia". Hepatology. 49 (2): 658–64. 2009. doi:10.1002/hep.22709. PMID 19177576.
- ↑ Karabork A, Kaygusuz G, Ekinci C (2010). "The best immunohistochemical panel for differentiating hepatocellular carcinoma from metastatic adenocarcinoma". Pathol. Res. Pract. 206 (8): 572–7. doi:10.1016/j.prp.2010.03.004. PMID 20400233.