title: Transjugular liver biopsy: how good is it for accurate histological interpretation?
abstract: BACKGROUND
  A transjugular liver biopsy (TJLB) specimen is often smaller or more fragmented than a percutaneous liver biopsy (PLB) specimen. Recently, for PLB, the minimum requirements to evaluate chronic hepatitis have been set at 20-25 mm length and > or =11 complete portal tracts.
  
  
  OBJECTIVE
  To evaluate and compare length of TJLB and PLB specimens, portal tract number, fragmentation and adequacy for histopathological diagnosis and staging.
  
  
  METHODS
  326 consecutive TJLB specimens in 274 patients (109 who had undergone a transplantation), always using three passes (19-G Tru-cut) and 40 consecutive PLB specimens (15-G Menghini).
  
  
  RESULTS
  No technical failures occurred with the TJLB, and histological diagnosis was possible in 98.5%. The median (range) number of fragments was 5 (1-13) and the median total length was 22 (3-46) mm, with 65% of specimens > or =20 mm and 36% > or =25 mm; 60% of TJLB specimens were > or =28 mm long had > or =11 complete portal tracts. No difference in complete portal tract number or biopsy length was found between PLB and TJLB specimens.
  
  
  CONCLUSIONS
  A TJLB specimen with three passes is adequate for histological diagnosis, with 89% of specimens being either > or =15 mm or having > or =6 complete portal tracts. Although adequate sampling remains a limitation for staging and grading of chronic hepatitis, TJLB is comparable to PLB in this respect.
authors.affiliation: Liver Transplantation and Hepatobililary Medicine, Royal Free Hospital, Pond Street, Hampstead, London NW3 2QG, UK.
authors.forename: E
authors.initials: E
authors.lastname: Cholongitas
authors.forename: A
authors.initials: A
authors.lastname: Quaglia
authors.forename: D
authors.initials: D
authors.lastname: Samonakis
authors.forename: M
authors.initials: M
authors.lastname: Senzolo
authors.forename: C
authors.initials: C
authors.lastname: Triantos
authors.forename: D
authors.initials: D
authors.lastname: Patch
authors.forename: G
authors.initials: G
authors.lastname: Leandro
authors.forename: A P
authors.initials: AP
authors.lastname: Dhillon
authors.forename: A K
authors.initials: AK
authors.lastname: Burroughs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D005260:Female; D019698:Hepatitis C, Chronic / Q000473:pathology; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000473:pathology; D008103:Liver Cirrhosis / Q000473:pathology; D008107:Liver Diseases / Q000473:pathology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011168:Portal System / Q000473:pathology