Percutaneous US-guided liver biopsy in focal lesions using a semiautomatic device allowing to perform multiple biopsies in a single-pass.

AIM: The aim of this study was to evaluate the safety and efficacy of percutaneous real-time ultra sound METHODS: One hundred and thirty-four consecutive percutaneous liver biopsies were performed in equal number of patients with focal liver lesions during a three-year period. All biopsies were performed with a single puncture, using a Tru-cat semiautomatic 18G needle (Precisa semi-automatic Tru-cut biopsy Device, HS Hospital Service, Italy) with removable inner stylet, under real-time US-guided. Two to five samples were obtained from each biopsy. In 12 cases an embolization of the biopsy track was performed. Thirty-two patients with hepatocellular carcinoma were followed for a period of 30-880 days for seeding. RESULTS: A total of 424 specimens were obtained from 134 biopsies. Evaluation of the biopsy specimens demonstrated that the 58.5% of them were >10 mm in length providing sufficient liver tissue for reliable histological diagnosis. The diagnosis was successful in 99.25% of the patients. No major complications or death occurred in our study group. Neither suspected nor confirmed tumor seeding was identified. CONCLUSION: Our results provide evidence that US-guided percutaneous liver biopsy using a semiautomatic 18G Tru-Cut needle with removable inner stylet can be performed with safety and efficacy in patients with focal liver lesions. Further-more, there are strong indications that the use of an introducer that remains in position during multiple cutting needle passes, protects normal tissue along the track and minimizes "seeding" and bleeding complications.

Liver resection in cases of isolated hepatic actinomycosis: case report and review of the literature.

Hepatic actinomycosis is an uncommon entity that forms communicating abscesses and fistulae. We report a 53-y-old immunocompetent male patient with hepatic actinomycosis. Symptoms included intermittent fever, abdominal pain, right upper quadrant tenderness and jaundice. A hepatic tumour mass was found on abdominal sonography and computerized tomography. Two preoperative percutaneous core biopsies of the mass were not diagnostic. The above findings were highly suggestive for liver abscess or purulent primary liver neoplasm. Treatment with intravenous antibiotics was continued for 20 d, but both symptoms and liver ultrasound findings remained unchanged. The patient underwent exploratory laparotomy and right posterior segmentectomy of the liver. Pathological examination of the surgically removed specimen disclosed hepatic actinomycosis. Following operation the patient remains in excellent condition without evidence of recurrence.