Large-needle biopsy versus thin-needle biopsy in diagnostic pathology of liver diseases

Background/Aims: A study was carried out to determine whether thin-needle biopsy (TNB) yields enough material to study diffuse liver diseases. Methods: Using TNB (20G and 21G) and a conventional Menghini-type large-needle biopsy (LNB; 17G), the amounts of tissue obtained and the histopathological diagnoses were compared. The biopsies were obtained by surgeons with a several-stroke method (17G(S)) and by physicians with a single-strike method (17G(P), 20G(P), 21G(P)). A total of 343 biopsy specimens from 258 patients were included in the study. Results. A comparison of the mean values for the length of the core biopsy, as well as the mean numbers of portal tracts and terminal hepatic veins among the four groups showed significant differences (P<0.001): the mean number of portal tracts obtained with 17G(S) was 13.8<plus/minus>6.5, with 17G(P) it was 9.7 +/-5.9, with 20G(P) it was 6.7 +/-4.4, and with 21G(P) it was 4.0 +/-3.1. A comparison of the histopathological diagnoses showed no major differences between 17G(P) and 20G(P); the diversity and frequencies of the diagnoses were similar. Conclusion: We suggest that the use of TNB, particularly 20G-size needles, could be extended to the investigation of diffuse liver diseases in which LNB carries a high risk of complications or is contraindicated, and when the diagnosis is the primary reason for the biopsy rather than grading or staging of a known diffuse disease.