Liver biopsy questions...

[Cthulwhoo]

Hi I have a question, can liver biopsy miss cirrhosis? I had mine and it showed no fibrosis and mild fatty liver. My hepatologist says it pretty much rules it out. Just your thoughts?

[angse]

Biopsy accurate Chulwoo

I had scans on liver, that came back clear, but my bloods were still showing high liver function, so gastroenterolgist said must have biopsy, and that showed advanced cirrohiss, so for me it was life saving, as scan showed healthy liver ??? Glad your OK. Annette

[Hidden]

Cthulwhoo it depends on the cause of any suspected Liver issues. Hep-c can create a sporadic pattern of scarring and the chances of a biopsy being inaccurate are around 30%. If its alcohol the damage is much more uniform and the biopsy should be accurate. A biopsy has a sample area of 1/50000th of the liver,alot now prefer the Fibroscan because its sample area is 1/500th of the liver and right in the portal area.

Looking at your history you would be the unluckiest guy ever to have liver disease! Ultrasounds, 2 x Fibroscans, biopsy, you need to think about the chances of all these missing this combined, it would be nearly impossible!

Also don't forget even if your liver has taken a little battering from booze, if you don't drink it should recover any lost ground.

I thought the root of your issues was your Kidneys? how are you doing with that?

[Stupidliver]

Yes a biopsy can definitely miss cirrhosis.the liver does not scar everywhere evenly.If the sample comes from an area that is not scarred it can give you a false negative.If it comes back positive then it's 100%.I don't know how uniform the scarring is in regards to which cause but it is common to get a false negative.It sounds like your in the clear especially if your INR, Bilirubin and AST are in normal range.An elevated ALT just tells you their is recent inflammation in hepatocytes going on !

Looks to me you are probably good .

[ballie52]

I had normal LfT for years and normal ultra sound scans... on a Biopsy it showed cirrhossis and grade 4 i think a biopsy is the only real way to detect any real damage going on in the liver...i was .told it gives a true picture of the state of your liver if you have any damage.

[briccolone in reply to ballie52]

sorry to hear that ballie but did you have any symptoms? why were you having the tests in the first place?

[ballie52]

Hi briccolone i have hep c...had it for about 20yrs ..when i found out they started routine blood tests..i was told that it was only a small chance it would progress... at biopsy showed mild illness only a few yrs before..i was treated with interferon and Ribba for 48 wks..it came back within the 12wks of stopping the treatment...i was asked about two yrs later if i wanted another biopsy and told that it would most likely show mild damage as before...was i in for a shock in 2yrs i developed cirrhosis although all my bloods came back as normal..if it was not for me going ahead with the biopsy i would have never even known....i did have symptoms but just thought it was nothing to worry about..in the end liver disease sometimes does not show damage in blood tests until things become more advanced...my tests are only just showing changes now and i have quite advanced damage...i think the latest fibro scans can give a good clue to liver damage without having to go through a liver biopsy.

[briccolone in reply to ballie52]

the more I read on this forum the more that I understand that everyones experience is different. I had symtoms which I ignored of course until I couldnt ignore them any longer. I was lucky in retrospect to exhibit symptoms-many people suddenly find they have serious conditions with no warning. good luck with your further treatments/prognosis. keep us posted