Liver Biopsy (cont.)
David C. Wolf, M.D., FACP, FACG, AGAF
IN THIS ARTICLE
Type of Tissue That Is Undergoing Biopsy
In most circumstances, liver biopsy is being performed to diagnose a condition that affects the entirety of the liver. Whether a patient has a chronic viral infection like chronic hepatitis B or C, or an autoimmune disease like primary biliary cirrhosis, or a metabolic disease like hereditary hemochromatosis, it is anticipated that the underlying disease process affects all regions of the liver equally. A small piece of tissue that is being removed from the right lobe of the liver is expected to be representative of the disease process that is affecting the liver as a whole. Unfortunately, this expectation is incorrect in some individuals. A minority of patients will have conditions where one area of the liver may be affected more than another area. This may lead to diagnostic inaccuracy.
Other patients require liver biopsy in order to diagnose a mass of tissue within the liver that was identified by an imaging study of the liver. Some masses are benign; others are malignant or cancerous. With so-called "guided" biopsies, the patient undergoes either an ultrasound or a computerized tomography (CT scan) at the time of the biopsy. The physician performing the biopsy (typically an interventional radiologist) uses the results of ultrasound or that scan to guide the biopsy needle to the mass. In CT-guided biopsies, the biopsy is performed while the patient is actually lying upon the CT table.
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