Treatment Type: Diagnostic Procedures
Rated for: German Shepherd Dog
Posted Jun. 26, 2018
Hepatocellular adenomas don't cause clinical signs, unless they rupture and hemorrhage, they are usually accidental findings on x-rays or ultrasound exam, and once we find a mass on the liver, we have to do further diagnostics in order to know if we need to remove it, use chemotherapy, some other treatment or we can leave it there and keep an eye on it. Advanced imaging techniques like MRI which can reliably differentiate between malignant and non-malignant hepatic masses. Despite very high specificity and sensitivity of advanced imagining techniques in the differentiation of malignant disease, they can't reliably differentiate between different kinds of tumors thus a biopsy is still necessary to get a definitive diagnosis and plan an appropriate treatment protocol.
There are two options when taking a liver biopsy, first is ultrasound-guided fine needle aspiration, which easier to do, doesn't require general anesthesia nor any special preparation. Whilst this method is more convenient, it can only produce samples for cytology examination, not histology. Cytology can quite conclusive in some cases, especially for diagnosing diffuse tumors, but in general, it's sensitivity is about 30-50%.
Direct sampling using laparoscopy or laparotomy to take full thickness tissue samples is more reliable as it can be sent for histology examination which is much more precise, but it requires coagulation tests, general anesthesia, surgery, and ideally intensive monitoring for 24h after the procedure.