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
Fiterman Centre for Digestive Disease, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Clin Gastroenterol Hepatol. 2008 Dec;6(12):1437-40. doi: 10.1016/j.cgh.2008.07.015. Epub 2008 Jul 26.
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.
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.
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).
EUS-guided Trucut left liver lobe biopsy yields suitable aggregate tissue for diagnostic purposes to establish the presence of chronic liver disease.
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。
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。
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)。
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。