Pathologie hépatique Cirrhose et carcinome hépatocellulaire : indications et rôles de la biopsie hépatique

Most hepatocellular carcinomas (HCC) arise in a background of chronic liver diseases leading to cirrhosis via the development of preneoplastic nodules. According to the last international recommendations, biopsy for HCC diagnosis is restricted to liver nodules > 1 cm with atypical features on imaging. High grade dysplastic nodule is the main differential diagnostic of HCC, and the use of immunohistochemistry with specific markers has shown a significant added-value. HCC prognosis may also be evaluated on biopsy, mainly via the evaluation of tumor differentiation. Lastly, risks of biopsy are really limited, with a low prevalence of tumor dissemination.