What is the role of biopsy in the workup of hepatocellular adenoma (HCA)?

Updated: Feb 21, 2018
  • Author: Bradford A Whitmer, DO; Chief Editor: BS Anand, MD  more...
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Answer

Results of histologic evaluation with a liver biopsy are nondiagnostic and insensitive because the mass is comprised of normal-appearing hepatocytes.

However, a study evaluating immunohistochemical markers on needle biopsies compared against surgical specimens found that immunohistochemistry allowed for the discrimination of focal nodular hyperplasia from hepatocellular adenoma and allowed for identification of hepatocelluar adenoma subtypes proposed in the new Bordeaux classification with 74.3% certainty. Further studies are needed. [50]

In a retrospective review (2000-2013) of the electronic medical records of all patients who underwent hepatic mass biopsy revealing hepatocelluar adenoma, Doolittle et al investigated the safety and outcomes of biopsy of these lesions. [51] Of 60 identified patients with a total of 61 biopsy-proven hepatocelluar adenomas, they found that 1 patient (2%) had a single major complication and 6 patients (10%) had a minor complication. In addition, they found 6 (10%) discordant biopsy results. [51]

Resection and evaluation may be required as the most specific way to confirm the diagnosis.


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