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How often do our liver core biopsies reach current definitions of adequacy?
  1. Eve Fryer1,
  2. Lai Mun Wang1,
  3. Clare Verrill2,
  4. Kenneth Fleming3
  1. 1Department of Cellular Pathology, John Radcliffe Hospital, Oxford, UK
  2. 2Department of Cellular Pathology and Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
  3. 3Department of Cellular Pathology and Oxford University, John Radcliffe Hospital, Oxford, UK
  1. Correspondence to Dr Eve Fryer, Department of Cellular Pathology, Level 1, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK; evefryer{at}doctors.org.uk

Abstract

Needle core biopsy is a key tool in diagnosis and assessment of many medical liver diseases, but there is evidence that the combination of small size of the specimen obtained and the patchy nature of many of these diseases can result in misdiagnosis or incorrect staging. The Royal College of Pathologists has therefore published guidelines for assessment of adequacy. To assess whether these guidelines were being observed, we reviewed cases reported in our department over a 15-year period. Results showed that only 19.8% of cores would be considered adequate, 56.4% were suboptimal and 23.8% were inadequate. We discuss the issues around recommendations on the minimum size of liver biopsies, potential factors limiting biopsy size and whether further refinement of the guidelines for adequacy is required.

  • Liver Disease
  • Audit
  • Hepatitis

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