Changing Role of Liver Biopsy Indications in A Tertiary Care Centre

A Histopathological Study

  • Kalaranjini K V Sree Gokulam Medical College and Research Foundation, Venjaramoodu, Kerala, India
  • Jinu Abraham Glaxon Sree Gokulam Medical College and Research Foundation, Venjaramoodu, Kerala, India
  • Sheela Vasudevan Sree Gokulam Medical College and Research Foundation, Venjaramoodu, Kerala, India
Keywords: Liver biopsy, chronic liver disease, cirrhosis, steatohepatitis

Abstract

Background: The histomorphological study of liver biopsy is the best means to ascertain the nature and signifi­cance of pathological processes occurring in the liver. The current non-invasive tools are unqualified to replace liver biopsy in clinical practice. Methods: This is a one year prospective study from January 2017 to 2018. A total of twenty five cases suspected to have chronic parenchymal liver disease, inflammatory lesions or neoplastic lesions were included in the study. Detailed history and investigations done including biochemical parameters, radiological and other investigative procedures done were recorded and percutaneous liver biopsy was done using trucut needle. Results: Out of the total 25 liver biopsy done, 60% cases were male, 40% were females. Majority of the patients belonged to the sixth decade (32%). Youngest patient was a 12 year boy with history of intermittent jaundice since birth, and the oldest patient was a 78 year old male. The most prevalent pathological diagnosis was cirrhosis with steatohepatitis with 7 cases (28%), followed by Non Alcoholic Fatty Liver Disease (NAFLD) and autoimmune hepatitis, 12% each. Conclusion: Liver biopsy is the gold standard for diagnosis of chronic liver diseases and plays a valuable role in diagnosis, prognostic and management of liver diseases.

Author Biographies

Kalaranjini K V, Sree Gokulam Medical College and Research Foundation, Venjaramoodu, Kerala, India
Department of Pathology
Jinu Abraham Glaxon, Sree Gokulam Medical College and Research Foundation, Venjaramoodu, Kerala, India
Department of Pathology
Sheela Vasudevan, Sree Gokulam Medical College and Research Foundation, Venjaramoodu, Kerala, India
Department of Pathology

References

1. Verma A, Sinha S, Panicker NK. The clinicopathological correlation in suspected cases of chronic liver disease with the aid of liver biopsy – a study in tertiary health centre. Int J Med Sci Public Health 2016;5:2615-19.
2. Torbenson M. Biopsy Interpretation of the liver. 3rd ed. Philadelphia PA: Wolter Kluwer; 2015.
3. Burt A, Portmann B, Ferrell L. MacSween's pathology of the liver. 6th ed. London: Churchill Livingstone; 2012.
4. Robert D. Odze, John R. Goldblum. Odze And Goldblum Surgical Pathology of the GI Tract, Liver, Biliary Tract, and Pancreas. Philadelphia, PA :Saunders/Elsevier; 2015.
5. Gao ZH, Tretiakova MS, Liu WH, Gong C, Farris PD, Hart J. Association of E-cadherin, matrix metalloproteinases, and tissue inhibitors of metalloproteinases with the progression and metastasis of hepatocellular carcinoma. Mod Pathol 2006; 19: 533–40.
6. Wang CH, Mo LR, Chang KK, Lin RC, Kuo JJ. A cohort study to investigate hepatocellular carcinoma risk in hepatitis C patients. Hepatogastroenterology. 2011 May-Jun; 58: 904–8.
7. Gelb AM, Mildvan D, Stenger RJ. The spectrum and causes of liver diseases in narcotic addicts. Am J Gastroenterol. 1977 Apr; 67: 314–8.
8. Chawla N, Sunila S. Spectrum of Histopathological Findings in Liver Biopsy. Indian Medical Gazette. 2013 Oct 363-7.
9. Laurin J. Motion - all patients with NASH need to have a liver biopsy: arguments against the motion. Can J Gastroenterol. 2002 Oct; 16: 722–6.
10. MacSween R.N.M., Scott A.R. — Hepatic cirrhosis: A Clinicopathological review of 520 cases. J ClinPathol. 26:936- 42, 1973.
11. Luketic VA, Schiffman ML. Benign recurrent intrahepatic cholestasis. Clin Liver Dis 1999;3:509-28.
12. Geethalakshmi S, Mageshkumar S. Benign Recurrent Intrahepatic Cholestasis: A Rare Case Report. Int J Sci Stud 2014;2(7):222- 4.
13. Gupta V, Kumar M, Bhatia BD. Benign recurrent intrahepatic cholestasis. Indian J Pediatr 2005;72:793-4
14. Ferrell L, Kakkar S. Liver pathology. 4th ed. New York: Demos Medical Publishing; 2012.
15. Aithal GP, Haugk B, Das S et al. Monitoring methotrexate-induced hepatic fibrosis in patients with psoriasis: are serial liver biopsies justified? Aliment Pharmacol Ther; 2004 Feb 15;19(4):391-9.
Published
2019-10-01
Section
Original Article