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. 2003 Aug;39(2):239-44.
doi: 10.1016/s0168-8278(03)00191-0.

Impact of liver biopsy size on histological evaluation of chronic viral hepatitis: the smaller the sample, the milder the disease

Guido Colloredo  1 , Maria Guido, Aurelio Sonzogni, Gioacchino Leandro
Affiliations

Impact of liver biopsy size on histological evaluation of chronic viral hepatitis: the smaller the sample, the milder the disease

Guido Colloredo et al. J Hepatol. 2003 Aug.

Abstract

Background/aims: In chronic viral hepatitis, liver biopsy is performed for assessing disease activity and fibrosis. In this study, we evaluated the impact of the size of liver biopsy on the grading and staging.

Methods: We selected 161 liver biopsies from patients with chronic types B and C hepatitis on the basis of their length (> or =3 cm) and width (1.4 mm). Ishak scoring system was used for grading and staging. The score was blindly repeated reducing the length of the specimen from > or =3 to 1.5 cm and to 1 cm long and width from 1.4 to 1 mm.

Results: Reducing the length of the biopsy led to an increase of cases with mild grades: 49.7% in > or =3 cm, 60.2% in 1.5 cm and 86.6% in 1 cm long specimens (P<0.001). Similarly, cases staged as having mild fibrosis significantly increased in the shorter specimens: 59% in > or =3 cm, 68.3% in 1.5 cm and 80.1% in 1 cm long specimens (P<0.001). As for the width, both grade and stage were significantly underscored in the 1 mm samples, regardless of their length.

Conclusions: Liver biopsy size strongly influences the grading and staging of chronic viral hepatitis. The use of fine needles should be discouraged in this setting.

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Comment in

  • Pathologist's perspective on liver needle biopsy size?
    Demetris AJ, Ruppert K. Demetris AJ, et al. J Hepatol. 2003 Aug;39(2):275-7. doi: 10.1016/s0168-8278(03)00282-4. J Hepatol. 2003. PMID: 12873827 Review. No abstract available.
  • Length versus width in liver biopsies.
    Cholongitas E, Quaglia A, Dhillon AP, Patch D, Burroughs AK. Cholongitas E, et al. J Hepatol. 2006 Apr;44(4):822-3; author reply 823-4. doi: 10.1016/j.jhep.2005.12.023. Epub 2006 Feb 3. J Hepatol. 2006. PMID: 16488508 No abstract available.

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