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Liver Biopsy: Stage, Grade, and Much More
We often discuss the diagnostic value of biopsy in regards to Stage and Grade in estimating fibrosis, but a good liver biopsy reviewed screened and reviewed by an expert pathologist can provide essential and valuable information.  A good reminder to everyone why it's important to get copies of all your lab reports.

Title:  Liver Biopsies in Chronic Viral Hepatitis Beyond Grading and Staging  
Author:  Hudacko, R / Add.Author / Editor:  Theise, N  
Citation:  ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE 135 (10): 1320-1328 OCT 2011  
Year:  2011  

"Abstract:  Context.-Knowledge of the etiology and pathogenesis of chronic viral hepatitis has grown immensely during the past 50 years. The terminology used to assess liver biopsies with chronic viral hepatitis and the role of the liver biopsy itself have also evolved during this time. Although the focus of much discussion regarding diagnostic assessment of liver biopsies in patients with viral hepatitis has been on grading of activity and staging of fibrosis, each biopsy is also an opportunity to assess many other important features.

Objectives.-To discuss opportunities provided by biopsies to assess features such as the presence of virus-associated premalignant or malignancy-related changes, and the presence of other concomitant diseases, including fatty liver disease of diverse causes, and hemochromatosis, hereditary or otherwise.

Data Sources.-The data were obtained from published literature and professional experience.

Conclusions.-The evaluation of liver biopsies with chronic viral hepatitis has evolved beyond grading and staging. Pathologists need to be aware of the other features that may have important clinical implications. "

http://www.archivesofpathology.org/doi/full/10.5858/arpa.2011-0021-RA
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446474_tn?1446351282
Thanks for posting.
A very good point showing that there is a lot more to a biopsy then what meets the untrained eye.

* A nice overview for patients is HCV Diagnostic Tools: Liver Biopsy
from the Hepatitis C Support Project.

http://www.hcvadvocate.org/hepatitis/factsheets_pdf/Biopsy.pdf

* For the hardcore people who want to understand liver biopsy from the clinician's point of view. The AASLD position paper "Liver Biopsy" published in HEPATOLOGY, Vol. 49, No. 3, 2009 is an A-Z summary of the current practice of liver biopsy.

https://aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/Liver%20Biopsy.pdf

Cheers!
Hector
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148588_tn?1451677687
Oh boy. I'm planning on seeing my gastro next month to ask him about having another bx since it's been over 10 years since my last. He already thinks I ask too many questions. If he finds out I favorited this to study, he'll tell me I don't need one.
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