title: How often do our liver core biopsies reach current definitions of adequacy?
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.
authors.affiliation: Department of Cellular Pathology, John Radcliffe Hospital, , Oxford, UK.
authors.forename: Eve
authors.initials: E
authors.lastname: Fryer
authors.forename: Lai Mun
authors.initials: LM
authors.lastname: Wang
authors.forename: Clare
authors.initials: C
authors.lastname: Verrill
authors.forename: Kenneth
authors.initials: K
authors.lastname: Fleming
mesh_terms: D062005:Biopsy, Large-Core Needle / Q000379:methods / Q000592:standards*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000473:pathology*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies
keywords: Audit; Hepatitis; Liver Disease