**5. Histologic diagnosis and clinical correlation**

The pathological report that used to be too descriptive now has to include etiology, aspects related to prognosis and possible therapy [12,13].

In order to promote the clinico-pathological diagnostic correlation with the intention of im‐ proving communication and clarifying individual cases, regular meetings between clinicians and pathologists are necessary. It is not only important to hold formal conferences but also to increase daily exchanges. To facilitate the communication between pathologists, radiologists, surgeons and clinicians it is desirable, when feasible, for the same teams to work together.

**Chronic viral hepatitis Primary Biliary Cirrhosis (PBC) Autoimmune Hepatitis**

(i.e. biliary piecemeal necrosis)

Duct destruction present May be present

Rethinking the Role of Liver Biopsy in the Era of Personalized Medicine

plasma cells

http://dx.doi.org/10.5772/53120

39

Present

Mononuclear cells Mononuclear cells; eosinophils Mononuclear cells;

Lobular necrosis Variable degree usually focal Variable; usually mild and focal Severe, may be confluent

Here we will discuss some of the most prominent findings of liver biopsy in the following

**b.** Metabolic diseases: Hemochromatosis, Porphyria, Wilson disease, Alpha 1- anti-trypsin

**c.** Autoimmune and cholestatic diseases: Auto-Immune Hepatitis, Primary Biliary Cirrho‐

**e.** Non-alcoholic Fatty Liver Diseases and Non-Alcoholic Steato-Hepatitis (NAFLD and

**i.** Hepatocellular Carcinoma (HCC) and other benign or malignant focal lesions. The role of the fine neddle aspiration biopsy (FNAB) and other imaging diagnostic tools.

**j.** New evolving fields for liver biopsy: Liver transplantation and living donors. Bone

In the past the majority of liver biopsies were performed in chronic hepatitis C patients. However, recently this has changed, due to a better understanding of the etiology, patho‐

sis (PBC), Primary Sclerosing Cholangitis (PSC), Overlap Syndrome.

Interface hepatitis Common Common;ductular reaction

**Table 3.** Specific features in liver biopsy differential diagnosis and pathological findings

Bile duct damage Common in hepatitis C

(usually mild)

**7. Use of liver biopsy in clinical practice**

**a.** Viral Hepatitis : Hepatitis B, Hepatitis C.

Portal tract inflammation

clinical settings:

disease.

**d.** Alcoholic liver disease

NASH). Liver steatosis.

**f.** Drug-Induced Liver Injury (DILI).

**h.** Cirrhosis. Fibrosis progression.

**7.1. Chronic viral hepatitis C and B**

**g.** Infections and pyrexia of unknown origin.

marrow transplantation. Morbid obesity

genesis, the natural history of the disease and available therapies.
