Transjugular liver biopsy – Indications, adequacy, quality of specimens, and complications – A systematic review

Kalambokis, Georgios; Manousou, Pinelopi; Shusang, Vibhakorn; Marelli, Laura; Cholongitas, Εvangelos; Senzolo, Marco; Patch, David; Burroughs, Andrew K.

doi:10.1016/j.jhep.2007.05.001

Cited by 349 publications

(360 citation statements)

References 78 publications

(91 reference statements)

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“…If a discrete mass is not visible on imaging for percutaneous liver biopsy (PLB), the transjugular approach may be reasonable [3]. A recent review indicates that transjugular liver biopsy can be used to obtain adequate tissue samples and major complications and mortality rates are similar to PLB [22]. Although most patients are treated with chemotherapy, with some physicians employing a multimodality approach that incorporates surgery and radiotherapy, the optimal treatment of PHL is not yet defined [2].…”

Section: Discussionmentioning

confidence: 99%

Primary Hepatic Marginal Zone B Cell Lymphoma : A Case Report and Review of the Literature

Kim

Byun

et al. 2012

Indian J Surg

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Background Primary hepatic lymphoma (PHL) is a very rare malignancy, and constitutes about 0.016 % of all cases of non-Hodgkin's lymphoma and is often misdiagnosed. The optimal therapy is still unclear and the outcomes are uncertain. Among PHLs, a primary hepatic low-grade marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is extremely rare. Methods We present a case of primary hepatic lymphoma (MALT lymphoma) treated with surgical resection and adjuvant chemotherapy. A 38-year-old Korean man, who was diagnosed with chronic hepatitis B 20 years ago, was admitted for liver biopsy after liver lesions were detected on follow-up computed tomography scan (CT). Liver biopsy revealed the diagnosis of marginal zone B-cell malignant lymphoma (MALT lymphoma). The preoperative clinical staging was IE, given that no additional foci of lymphoma were found anywhere else in the body. The patient underwent left hemihepatectomy. Subsequently, the patient received two cycles of CHOP (cyclophosphamide, adriamycin, vincristine, and prednisone) regimen.Results After 15 months of follow-up, the patient is alive and well without any evidence of disease recurrence. Conclusion Although the prognosis is variable, good response to early surgery combined with postoperative chemotherapy can be achieved in strictly selected patients.

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Section: Discussionmentioning

confidence: 99%

Primary Hepatic Marginal Zone B Cell Lymphoma : A Case Report and Review of the Literature

Kim

Byun

et al. 2012

Indian J Surg

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“…Large controlled trials have yet to evaluate the connection between liver biopsy and amyloidosis though a small case series in the 1960s did mention the potential risk for bleeding [22]. In fact, recent research has emphasized the increased risk of bleeding from liver biopsy in patients with amyloid deposition though the transjugular approach has decreased such risks when compared to the percutaneous method [23,24]. Additionally, portal hypertension in the setting of hepatic amyloidosis can lead to severe complications, including subcapsular hematoma and spontaneous rupture of the liver [25,26].…”

Section: Discussionmentioning

confidence: 99%

Amyloidosis presenting as acute liver failure: a case report

Parikh¹,

Tsai²

2014

Intern Med Inside

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Introduction: Amyloidosis has two principle types: multiple myeloma-associated (AL) and amyloidassociated amyloidosis (AA). Both types can be local or systemic and can often involve the liver. Hepatic amyloidosis carries a poor prognosis, but commonly presents with a more gradual time course of evolving hepatomegaly and elevated serum alkaline phosphatase. This casereport involves an unusual presentation of hepatic amyloidosis with acute liver decompensation resulting in death. Case presentation: A 76 year old man presented with complaints of progressive weakness and anorexia resulting in weight loss. He was initially found to have laboratory abnormalities notable for cholestasis and a mild transaminitis. On exam, the patient was cachectic with scleral icterus, jaundice, and abdominal distention. Liver ultrasound with doppler imaging was significant for increased echogenicity of the liver and ascites. The patient underwent transjugular liver biopsy, which demonstrated hepatic amyloid. Additional testing revealed a diagnosis of amyloidosis secondary to multiple myeloma. On day 5 of the patient's admission, cholestasis and transaminitis acutely worsened, with eventual peaking of aspartate aminotransferase to 3362 u/l, alanine aminotransferase to 1439 u/l, and total bilirubin to 18.8 mg/d. Further work-up for this acute decompensation, including imaging and laboratory tests, did not reveal any triggering events such as portal vein thrombosis or intra-abdominal bleeding from recent liver biopsy. Additionally, cardiovascular compromise, infectious etiologies, and toxins were ruled out. Unfortunately, the patient was not a candidate for chemotherapy given his acute hepatic decompensation and subsequent encephalopathy on day 8 of admission. The patient was started on Lactulose and N-acetylcysteine, though his mental status continued to worsen and the patient died on day 10 of admission from multi-organ compromise secondary to acute liver failure. Conclusion: Amyloidosis resulting in acute hepatic failure has previously been reported but remains quite rare. Clinicians must consider infiltrative diseases, such as multiple myeloma and amyloidosis, when patients present with an extended prodromal illness paired with unexplained, worsening hepatic dysfunction. Likewise, physicians should be aware that patients who present with hepatic amyloid secondary to multiple myeloma are at high risk for rapid clinical deterioration.

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“…The complication rates are low and range from 1.3 to 6.5 % [32]. The majority of complications are minor and related to bleeding at the puncture site or abdominal pain related to the presence of a small hematoma distending the liver capsule.…”

Section: Complications Of Tjlbmentioning

confidence: 99%

“…Significant ascites and bleeding tendency are the most common indications for TJLB [32]. TJLB has been shown to have a diagnostic and prognostic role in those with acute hepatic failure [33].…”

Section: Indications Of Tjlbmentioning

confidence: 99%

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Asian-Pacific Association for the Study of the Liver (APASL) consensus guidelines on invasive and non-invasive assessment of hepatic fibrosis: a 2016 update

et al. 2016

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Transjugular liver biopsy – Indications, adequacy, quality of specimens, and complications – A systematic review

Cited by 349 publications

References 78 publications

Primary Hepatic Marginal Zone B Cell Lymphoma : A Case Report and Review of the Literature

Primary Hepatic Marginal Zone B Cell Lymphoma : A Case Report and Review of the Literature

Amyloidosis presenting as acute liver failure: a case report

Asian-Pacific Association for the Study of the Liver (APASL) consensus guidelines on invasive and non-invasive assessment of hepatic fibrosis: a 2016 update

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