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非恶性肝实质疾病的内镜超声核心针穿刺活检标本的充足性。

Adequacy of endoscopic ultrasound core needle biopsy specimen of nonmalignant hepatic parenchymal disease.

作者信息

Gleeson Ferga C, Clayton Amy C, Zhang Lizhi, Clain Jonathan E, Gores Gregory J, Rajan Elizabeth, Smyrk Tom C, Topazian Mark D, Wang Kenneth K, Wiersema Maurits J, Levy Michael J

机构信息

Fiterman Centre for Digestive Disease, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.

出版信息

Clin Gastroenterol Hepatol. 2008 Dec;6(12):1437-40. doi: 10.1016/j.cgh.2008.07.015. Epub 2008 Jul 26.

Abstract

BACKGROUND & AIMS: The adequacy and diagnostic yield of hepatic parenchymal disease Trucut biopsy have not been determined. Therefore, our aim was to determine the adequacy of endoscopic ultrasound (EUS)-guided Trucut liver biopsy for histopathologic evaluation to include the number of complete portal tracts contained per millimeter of acquired tissue.

METHODS

A single institution retrospective review was made of 9 prospectively identified patients who underwent a transgastric left liver lobe EUS-guided Trucut biopsy during a 36-month period.

RESULTS

Adequate diagnostic material, to include complete portal tract number evaluation (median, 7) and connective tissue staining, was acquired to establish a histopathologic diagnosis in all 9 cases. Sixty-three complete portal tracts were established, resulting in 0.4 portal tracts per millimeter of tissue acquired. Findings established by EUS Trucut left liver lobe biopsy included mild steatosis (n = 4), cryptogenic cirrhosis (n = 2), chronic ductopenic biliary tract disease (n = 1), portal fibrosis with ductular proliferation (n = 1), and alcoholic cirrhosis with hemosiderosis (n = 1).

CONCLUSIONS

EUS-guided Trucut left liver lobe biopsy yields suitable aggregate tissue for diagnostic purposes to establish the presence of chronic liver disease.

摘要

背景与目的

肝实质疾病Trucut活检的充分性及诊断率尚未确定。因此,我们的目的是确定内镜超声(EUS)引导下Trucut肝活检用于组织病理学评估的充分性,包括每毫米获取组织中所含完整门静脉分支的数量。

方法

对一家机构在36个月期间前瞻性确定的9例接受经胃左肝叶EUS引导下Trucut活检的患者进行回顾性研究。

结果

所有9例均获取了足够的诊断材料,包括完整门静脉分支数量评估(中位数为7)和结缔组织染色,以建立组织病理学诊断。共确定了63个完整门静脉分支,每毫米获取组织中有0.4个门静脉分支。EUS引导下Trucut左肝叶活检的结果包括轻度脂肪变性(n = 4)、隐源性肝硬化(n = 2)、慢性胆小管性胆道疾病(n = 1)、伴有小胆管增生的门静脉纤维化(n = 1)和伴有含铁血黄素沉着的酒精性肝硬化(n = 1)。

结论

EUS引导下Trucut左肝叶活检可获取适合诊断目的的聚合组织,以确定慢性肝病的存在。

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