[Hodgkin's disease and the liver. Study of 50 biopsies]

A study of 50 liver biopsies (LB) is presented from a series of 45 patients with Hodgkin's disease as diagnosed by node biopsy in 40, by laparoscopic liver biopsy (LLB) or surgery in 5, with a simultaneous positive bone marrow study in one case. A total of 34 LLB and 16 blind liver biopsies were carried out For diagnosis of the disease the LB was positive in 2/7 or 28.5%. In order to establish the clinical status as a pre-treatment staging procedure in 30 cases, the biopsy was useful in 10% of the cases; whereas during the evolution of the disease in order to establish restaging in 13 patients, positivity was observed in 1 case (7.6%). In 7/34 with laparoscopic changes of the hepatic surface, invasion was later determined by LLB, surgery or autopsy in 71%, whereas with a normal surface infiltration was only established in 18.5% In 12 patients with liver invasion as demonstrated by LLB, laparotomy or autopsy, alkaline phosphatase was increased in 91.6%. We consider that the elevated number of false negatives (58.3%) is due fundamentally to the single biopsy technique performed some years ago with the Vim-Silverman needle instead of the procedure in use at present o repeated biopsies in both lobes when possible. Our experience of 50 LB in these 45 patients has been most useful in arriving at a diagnosis in 2, determining a change in stage on 3 occasions, demonstrating peritoneal and spleen involvement in 2 cases in addition to revealing other hepatic alterations.(ABSTRACT TRUNCATED AT 250 WORDS)