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August 1979

Percutaneous Needle Biopsy SpecimensSampling Variability in Patients With Chronic Hepatitis and Cirrhosis

Author Affiliations

Department of Medicine and Section of Gastroenterology West Side Veterans Administration Hospital and University of Illinois 820 S Damen Ave Chicago, IL 60612

Arch Intern Med. 1979;139(8):856. doi:10.1001/archinte.1979.03630450010005

Our ability to diagnose and treat patients with liver disease has greatly improved in the last 40 years, and a major reason for these advances is the development of percutaneous needle biopsy techniques.1 Although liver function tests, immunologic markers, and radiologic examinations of the hepatobiliary system are helpful to the clinician, specific diagnosis, severity of the pathologic process, and need for therapy often can be determined only by examining the hepatic needle biopsy specimen. However, there are limitations that must be appreciated when interpreting hepatic needle biopsy specimens. These include sampling variability2-4; the fact that etiologic diagnosis cannot always be inferred from morphologic results4-6; and observer error.3,4-6 The study of Abdi et al, in the June Archives (139:667-669), addresses the first of these problems. Their autopsy study indicates that in several common hepatic diseases such as alcoholic hepatitis, venous congestion, and acute hepatitis, the liver is

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