Weiss Douglas J, Moritz Andreas
Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Minnesota, 1971 Commonwealth Avenue, St. Paul, MN 55108, USA.
Vet Clin North Am Small Anim Pract. 2002 Nov;32(6):1267-91, vi. doi: 10.1016/s0195-5616(02)00047-5.
Physical examination, clinical laboratory testing, and medical imaging are effective in establishing the presence of liver disease; however, they infrequently establish a definitive diagnosis. Morphologic evaluation of liver tissue is generally accepted as a valuable diagnostic tool in establishing a diagnosis in liver disease. Clinicians have several options for obtaining specimens for morphologic evaluation, including surgically obtained wedge biopsies, percutaneous core biopsies, and fine-needle aspiration specimens. Surgical and core biopsy procedures require anesthesia or sedation and have a substantial risk of bleeding complications. Fine-needle aspiration usually does not require sedation and is rarely associated with hemorrhage; thus, it is frequently chosen for animals that are poor anesthetic risks or have coagulopathies. Diseases like malignant lymphoma, hepatic lipidosis, and suppurative hepatitis are readily diagnosed cytologically, whereas hepatocellular adenomas, hyperplastic nodules, fibrosis, and chronic inflammation are more difficult to identify cytologically.
体格检查、临床实验室检测和医学成像对于确定肝脏疾病的存在是有效的；然而，它们很少能做出明确诊断。肝组织的形态学评估通常被认为是肝病诊断中的一种有价值的诊断工具。临床医生有几种获取形态学评估标本的选择，包括手术获取的楔形活检、经皮穿刺活检和细针穿刺抽吸标本。手术活检和穿刺活检程序需要麻醉或镇静，并且有出血并发症的重大风险。细针穿刺抽吸通常不需要镇静，很少与出血相关；因此，对于麻醉风险高或患有凝血病的动物，经常选择这种方法。恶性淋巴瘤、肝脂肪变性和化脓性肝炎等疾病很容易通过细胞学诊断，而肝细胞腺瘤、增生性结节、纤维化和慢性炎症则更难通过细胞学识别。
