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Hi all, I have a patient, 8 y.old, MN, JRT with diffuse changes in a relatively small liver and suspected microvascular dysplasia (no PSS shunt seen). I am going to take a tru cut biopsy but I am wondering, with these diffuse changes, if I should take just a single biopsy or more? I imagine the same device should not be used more than 1-2 times to avoid blunting? I would much appreciate your advice. Thanks in advanced.
Comments
Most devices can get at least
Most devices can get at least 5 cuts without an issue. I use the Bard monopty 2.2 cm cut then gas sterilize for use in the future. never had an issue.
Usually one solid “worm” of a sample is enough with a 16 gauge on a jack russel. More samples isf looking for copper or if the sampel is fragmented owing to fibrosis.
Small liver i use sdep 9 or 10 approach lower left intercostal to avoid the stomach.
Thanks much for the input.
Thanks much for the input. I’m afraid our needle is a temno coaxial biopsy system 18G 11cm with option of 1cm or 2 cm sample notch. I hope it still provides enough tissue architecture instead of the 16G…
I would do the 2 cm if you
I would do the 2 cm if you have 3 cm of tissue to aim at without bile tracts or vessels in the way. One solid sample should be ok but 2 better. 3 sampels of the 1 cm should do it if that’s your better option from a trajectory standpoint.
The objective is to get 3-4 portal triads at least to evaluate structure. So maybe add a note to the pathologist to ask how many portal triads were present? This way you kow how your sample technique did.
Here’s a course i did on sampling on our educational portal if you find it useful:
https://education.sonopath.com/courses/2218973/content
Good luck
Fantastic! Great information.
Fantastic! Great information. I’ll go through the course, too. I shall let you know. Many thanks.
Our pleasure
Our pleasure