A comparison between clinical diagnosis and histopathological findings in liver biopsies

In 70 consecutive patients the histopathological diagnosis of needle liver biopsy specimens and the clinical diagnosis were compared. The patients were divided into the following groups: alcoholic liver disease, hepatitis, malignancy, cholestasis, and miscellaneous. Nearly half of the cases were alcohol-induced; all of these showed changes in the specimens consistent with an elevated alcohol consumption, but their histopathological 'severity' did not correlate with the amount of alcohol consumption. In the hepatitis group three cases of acute viral hepatitis gave identical clinical and histopathological diagnoses. The malignancy group showed that in five of eight cases the needle biopsy specimen confirmed the clinical suspicion of malignant tumour in the liver. The histopathological diagnoses of the miscellaneous group were not able to add further information to the clinical findings because of unspecific lesions in the specimens. Two specimens were taken from each patient, and the 'reproducibility' of the histopathological diagnoses of the interdependent specimens showed a high degree of agreement: 71% of the biopsy pairs had identical diagnoses of the two specimens from the same patients, and 12% of the biopsy pairs had only small differences between the two diagnoses.