September 14, 2012

Liver biopsy or suction


In theory, a definitive diagnosis of liver cancer is always based on microscopic confirmation (by histology, the science of body tissue). However, some well-differentiated HCC, which means they are formed from liver cells (hepatocytes), which has been developed with full and ripe. Therefore, these cancers can look very similar to liver tissue is not cancerous under a microscope. Moreover, not all pathologists are trained to recognize subtle differences between the liver cancer that are distinguished by good and normal liver tissue. Also, some pathologists can mistake HCC for adenocarcinoma in the liver. An adenocarcinoma is a distinct type of cancer, and as mentioned previously, it originates from outside the liver. Most importantly, a metastatic adenocarcinoma would be treated differently from a primary liver cancer. Therefore, all of this considered, it is important that a pathologist reviewing the liver tissue slices of liver tumors in questionable situations.

Networks can be sampled with a very thin needle. This technique is called fine needle aspiration. When a larger needle is used to obtain a core network, the technique is called a biopsy. Generally, experts-radiologists, using ultrasound or CT scans to guide placement of the needle, perform biopsies or fine needle aspiration-suction. The most common risk of aspiration or biopsy is bleeding, especially because liver cancer is a tumor that is very vascular (contains many blood vessels). Rarely, foci (small areas) of the new tumor can be grown from the tumor by the needle into the liver along the needle path.
Suction procedure is safer than a biopsy with a smaller risk of bleeding. However, interpretation (interpretation) of the specimen (sample) is obtained by aspiration is more difficult because often only a group of cells available for evaluation. Thus, a fine needle aspiration requires a pathologist with high skills. Moreover, a core of tissue obtained by needle biopsy is more ideal for a definitive diagnosis because tissue architecture is preserved. The point is that sometimes a proper diagnosis can be clinically important. For example, some studies have shown that the degree of tumor differentiation may predict the prognosis (outcome) patients. It is said, is more differentiated (mimicking normal liver cells) the tumor, the better the prognosis.
From everything is said, in many instances, it may be no need for a tissue diagnosis by biopsy or aspiration. If a patient has a liver cancer risk factors (eg, cirrhosis, chronic hepatitis B, hepatitis C or chronic) and an alpha-fetoprotein blood levels are rising significantly, the doctor can be almost certain that the patient has liver cancer without doing a biopsy. Patients and physicians should always ask two questions before deciding to do a liver biopsy:
1.      Whether the tumor is most likely a liver cancer?
2.      Is the biopsy findings will change the management of patients?

If the answer to both questions is yes, then the biopsy should be performed. Finally, there are two other situations associated with liver cancer in which a biopsy may be considered. The first is to characterize (mark) of a liver abnormality (eg, a tumor that may be) seen by imaging (imaging) in the absence of risk factors for liver cancer or an increased alpha-fetoprotein. The second is to determine the extent of disease when there are multiple areas of abnormalities (possibly tumors) seen by imaging (imaging) in the liver.
Overall, there is no full recommendations can be given regarding the purpose of liver biopsy or aspiration. Decisions must be made on an individual basis, depending on treatment choices and expertise of medical teams and operations.
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Liver biopsy or suction


In theory, a definitive diagnosis of liver cancer is always based on microscopic confirmation (by histology, the science of body tissue). However, some well-differentiated HCC, which means they are formed from liver cells (hepatocytes), which has been developed with full and ripe. Therefore, these cancers can look very similar to liver tissue is not cancerous under a microscope. Moreover, not all pathologists are trained to recognize subtle differences between the liver cancer that are distinguished by good and normal liver tissue. Also, some pathologists can mistake HCC for adenocarcinoma in the liver. An adenocarcinoma is a distinct type of cancer, and as mentioned previously, it originates from outside the liver. Most importantly, a metastatic adenocarcinoma would be treated differently from a primary liver cancer. Therefore, all of this considered, it is important that a pathologist reviewing the liver tissue slices of liver tumors in questionable situations.

Networks can be sampled with a very thin needle. This technique is called fine needle aspiration. When a larger needle is used to obtain a core network, the technique is called a biopsy. Generally, experts-radiologists, using ultrasound or CT scans to guide placement of the needle, perform biopsies or fine needle aspiration-suction. The most common risk of aspiration or biopsy is bleeding, especially because liver cancer is a tumor that is very vascular (contains many blood vessels). Rarely, foci (small areas) of the new tumor can be grown from the tumor by the needle into the liver along the needle path.
Suction procedure is safer than a biopsy with a smaller risk of bleeding. However, interpretation (interpretation) of the specimen (sample) is obtained by aspiration is more difficult because often only a group of cells available for evaluation. Thus, a fine needle aspiration requires a pathologist with high skills. Moreover, a core of tissue obtained by needle biopsy is more ideal for a definitive diagnosis because tissue architecture is preserved. The point is that sometimes a proper diagnosis can be clinically important. For example, some studies have shown that the degree of tumor differentiation may predict the prognosis (outcome) patients. It is said, is more differentiated (mimicking normal liver cells) the tumor, the better the prognosis.
From everything is said, in many instances, it may be no need for a tissue diagnosis by biopsy or aspiration. If a patient has a liver cancer risk factors (eg, cirrhosis, chronic hepatitis B, hepatitis C or chronic) and an alpha-fetoprotein blood levels are rising significantly, the doctor can be almost certain that the patient has liver cancer without doing a biopsy. Patients and physicians should always ask two questions before deciding to do a liver biopsy:
1.      Whether the tumor is most likely a liver cancer?
2.      Is the biopsy findings will change the management of patients?

If the answer to both questions is yes, then the biopsy should be performed. Finally, there are two other situations associated with liver cancer in which a biopsy may be considered. The first is to characterize (mark) of a liver abnormality (eg, a tumor that may be) seen by imaging (imaging) in the absence of risk factors for liver cancer or an increased alpha-fetoprotein. The second is to determine the extent of disease when there are multiple areas of abnormalities (possibly tumors) seen by imaging (imaging) in the liver.
Overall, there is no full recommendations can be given regarding the purpose of liver biopsy or aspiration. Decisions must be made on an individual basis, depending on treatment choices and expertise of medical teams and operations.