Sampling variability and its influence on the diagnostic yield of percutaneous needle biopsy of the liver

Lancet. 1986 Mar 8;1(8480):523-5. doi: 10.1016/s0140-6736(86)90883-4.


In an investigation to determine the influence of sampling variability on the diagnostic yield of liver biopsy, 3 consecutive samples were obtained from each of 75 patients by redirecting the biopsy needle through a single entry site. In 14.7% of patients all 3 specimens were normal, and in 36% there were similar abnormalities in all 3 specimens. In the other patients, sampling variability between specimens was present. In those patients with cirrhosis, hepatocellular carcinoma, metastatic carcinoma, or hepatic granulomas the histological abnormality was present in all 3 biopsy specimens in only 50%, 54.5%, 50%, and 18.8% of patients, respectively. No complications were recorded. These findings show that important pathology can be overlooked if only a single biopsy specimen is taken, and that the method of obtaining 3 consecutive specimens improves the diagnostic yield of liver biopsy without an associated increase in complications.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biopsy, Needle* / methods
  • Carcinoma, Hepatocellular / diagnosis
  • Child
  • Female
  • Granuloma / diagnosis
  • Hepatomegaly / diagnosis
  • Humans
  • Liver / pathology*
  • Liver Cirrhosis / diagnosis
  • Liver Diseases / diagnosis*
  • Liver Diseases / pathology
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / secondary
  • Male
  • Middle Aged
  • Prospective Studies
  • Schistosomiasis / diagnosis
  • Tuberculosis, Hepatic / diagnosis