Percutaneous needle biopsy of hepatic cavernous hemangioma

In a retrospective review of percutaneous needle biopsy in 38 patients, we assessed the safety of this procedure for establishing the diagnosis of cavernous hemangioma of the liver. Computed tomography (CT) or ultrasound was used to direct the biopsy of focal liver lesions ranging in size from 1 to 13.5 cm, with a median size of 3 cm. In all patients, the pathological diagnosis was established conclusively on the basis of core tissue samples obtained using a 20-gauge cutting needle and an average of 2.7 passes. Biopsy was performed as an outpatient procedure in 31 patients (82%). Clinical or radiological follow-up of 30 patients for an average of 32 months (range 7-57 months) supported the pathological diagnosis of cavernous hemangioma. Despite the reported risk of hemorrhage, we performed biopsies on all patients without serious complication; five patients complained of transient right upper quadrant pain, that did not require treatment. We conclude that percutaneous needle biopsy (PNB) of the liver is a safe and effective procedure for establishing the diagnosis of cavernous hemangioma in patients who have no bleeding diathesis.