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Transjugular liver biopsy: how good is it for accurate histological interpretation?
  1. E Cholongitas1,
  2. A Quaglia2,
  3. D Samonakis1,
  4. M Senzolo1,
  5. C Triantos1,
  6. D Patch1,
  7. G Leandro1,
  8. A P Dhillon2,
  9. A K Burroughs1
  1. 1Liver Transplantation and Hepatobiliary Medicine, Royal Free Hospital, London, UK
  2. 2Histopathology Department, Royal Free Hospital, London, UK
  1. Correspondence to:
    A K Burroughs
    Liver Transplantation and Hepatobililary Medicine, Royal Free Hospital, Pond Street, Hampstead, London NW3 2QG, UK;Andrew.Burroughs{at}royalfree.nhs.uk

Abstract

Background: A transjugular liver biopsy (TJLB) specimen is often smaller or more fragmented than a percutaneous liver biopsy (PLB) 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 PLB 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 PLB 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.

  • H&E, haematoxylin and eosin
  • PLB, percutaneous liver biopsy
  • PPT, partial portal tracts
  • TJLB, transjugular liver biopsy

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Footnotes

  • Published Online First 24 April 2006

  • Competing interests: None.

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