Fontanges, Thierry

How to accurately interpret liver biopsy - 2022.


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Liver biopsy practice has decreased in recent years due to the use of noninvasive tests that are easier and more comfortable for the patient. However, this procedure remains mandatory in certain conditions: when major gaps are detected between several noninvasive tests; for ascertaining the etiology of liver damage when blood and morphological tests are not successful; and finally for therapeutic protocols. The main objective of this article is to help the practitioner understand and interpret the results of a biopsy in order to extract as much information as possible: sample quality, collaboration between the practitioner and the pathologist, location and type of lesion, and finally classification of liver fibrosis based on approved data. Precious information gathered from the patient on their medical background will also greatly help the pathologist in their interpretation. Throughout a chronic liver disease, it is of utmost importance to rely on a solid clinical history for the patient’s follow-up care. If acute alcoholic hepatitis is suspected, this biopsy remains unavoidable to confirm the diagnosis and decide on the therapeutic strategy. In other words, liver biopsy is synonymous with rigorousness and remains important for the practitioner.