The liver makes scores of different complex proteins from food, key among them being albumin and globulins.Virtually every vital mineral and hormone is attached to albumin in the bloodstream, which then carries them to various organs. Globulins are the cornerstone of the body's defenses and immune systems.

Other vital proteins made in the liver maintain a proper balance in the blood between clotting and bleeding, so that we don't clot too easily or hemorrhage from even a small cut. The liver also controls hundreds of chemical reactions in the body through the enzymes it makes. It stores substances such as sugar and releases them when you need them. It detoxifies them when you need them. It detoxifies medications you take so they don't accumulate and poison you.
The liver does it all. Thus a biopsy is an important diagnostic tool.

A liver biopsy is a diagnostic procedure used to obtain a small amount of liver tissue , which can be examined under a microscope to help identify the cause or stage of liver disease.

The most common way a liver sample is obtained is by inserting a needle into the liver for a fraction of a second. This can be done in the hospital, and the patient may be sent home within 3-6 hours if there are no complications. The physician determines the best site, depth, and angle of the needle puncture by physical examination or ultrasound. The skin and area under the skin is anesthetized, and a needle is passed quickly into and out of the liver. Approximately half of the patients have no pain afterwards while others will experience brief ,localized pain that will spread to the right shoulder.

Liver biopsy is often used to diagnose the cause of chronic liver disease that results in elevted liver tests or an enlarged liver.

It is also used to diagnose liver tumors identified by imaging tests. In many czses the specific cause of the chronic liver disease is highly suspected on the basis of blood test, but a liver biopsy is used to confirm the diagnosis as well as determine the amount of damage to the liver. Liver biopsy is also used after liver transplantation to determine the cause of elevated liver tests and determine if rejection present.

MARY'S LIVER BIOPSY

CLINICAL HISTORYp

pre-op HEPATITIS C

MICROSCOPIC DIAGNOSIS

LIVER, NEEDLE CORE BIOPSY

The specimen is labeled liver biopsy and consists of several thin and light tan core biopsies of tissue measuring up to 1.2 cm in length . Totally submitted in one cassette.
COMMENT: lymphocytic piecemeal necrosis can be identified involving some of the portal tract. There is relatively little lobular inflammation and necrosis. There is some portal fibrous expansion, but minimal periportal fibrosis. These changes are emphasized on trichrome stain. They correspond to chronic hepatitis, as diagnosed above. These changes are consistent with chronic hepatitis c in a patient with documented serologic history of such an entity. Special stain for iron demonstrates no significant increases in stainable iron