Liver Biopsy Introduction
For almost a century, physicians have employed liver biopsy to help diagnose the cause and assess the severity of their patients' liver disease. Liver biopsy entails the removal a small piece of tissue from the liver. That piece of tissue is then sent to the pathology laboratory for analysis.
Reasons for Liver Biopsy
Physicians typically employ a broad array of blood tests and imaging studies (for example, CT, MRI scans) in an effort to diagnose a patient's liver disease. In some circumstances, those tests do not lead to a diagnosis. A liver biopsy is a key tool in helping the physician make a correct diagnosis of a patient's underlying liver disease.
In some circumstances, a patient's clinical history, blood tests, or imaging studies may strongly suggest a particular diagnosis. Liver biopsy is used to confirm the physician's clinical suspicions. This is particularly important in view of the fact that many liver diseases require life-long therapy. Making a correct diagnosis is critical before committing the patient to a long course of treatment with a particular drug.
In other circumstances, blood test results may point to the co-existence of two liver diseases in the same patient at the same time (for example, alcoholic hepatitis as well as chronic hepatitis C). Thus, liver biopsy results may clarify whether a patient is suffering from one or two diseases.
Liver biopsy results may be used to monitor the effectiveness of therapy. As an example, a patient under long-term medical therapy for autoimmune hepatitis may require a follow-up liver biopsy to determine whether or not therapy is successful at suppressing the hepatitis.
Liver biopsy also can be used to assess the severity of a patient's condition. As an example, a patient's clinical history and laboratory tests might strongly point to a diagnosis of chronic hepatitis C (CHC). Knowledge of the severity of the patient's chronic hepatitis C will help determine whether the patient needs immediate therapy or whether therapy can be deferred to a later date.
David C. Wolf, M.D., FACP, FACG, AGAF
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