Liver mass diagnostic study of choice
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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 includes suspected hepatocellular carcinoma, and unspecific imaging findings. The most important contraindication for biopsy in liver mass is suspected liver hemangioma.
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. [1]
Indications
Indications for biopsy in liver mass, include:
- Suspected hepatocellular carcinoma[1]
- Unspecific and inconclusive liver mass imaging findings
Types
- Percutaneous, ultrasound-guided liver biopsy
- Laparoscopic liver biopsy
- Transjugular liver biopsy
| Disease | Findings on Biopsy |
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| Focal nodular hyperplasia |
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| Hepatocellular carcinoma | Two out of the following three positive stains upon liver biopsy confirm HCC:[2][3] |
| Cirrhosis |
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Contraindications
- Contraindications for biopsy in liver mass, include:[1]
- 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:[1]
- Bleeding
- Seeding of neoplastic cells
References
- ↑ 1.0 1.1 1.2 1.3 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.