Histopathological Findings In Liver Biopsies And Clinical Correlation At Kano, Nigeria

Abstract

Background: Proper evaluation of liver disease requires histological diagnosis of liver biopsy specimens which form the basis for rational treatment and monitoring, as well as assessment of disease severity and progression. We report the histological findings in liver biopsy specimens obtained by percutaneous blind needle biopsy in Kano, Nigeria over a two year period (February 2002-April 2004).
Materials and methods: Percutaneous blind needle liver biopsy (PBNLB) was performed in 37 consecutive patients with clinical, laboratory and ultrasonographically established liver disease using the Menghini suction needle after observing necessary precautions. Liver tissues obtained were processed and stained with Haematoxylin and Eosin (H&E), reticulin and Masson's trichrome stains before being reported on by a Histopathologist.
Results: Adequate liver tissues were obtained in 36 patients with one reported as inadequate sample for histological assessment giving a failure rate of 0.027% for this study. The Commonest histological finding was chronic hepatitis accounting for 15 (40.5%) followed by PLCC in 10 (27%) of the patients. The other findings were cirrhosis in 5 (13.5%), extra hepatic biliary obstruction in 2 (5.4%) normal histology in 2 (5.4%), cholestatic hepatitis in 1 (2.7%), while reactive changes and inadequate sample were each reported in 1(2.7%) of the patients.
Thirty two (86.5%) and 1 (2.7%) of the patients were positive for HBV and HCV respectively. The prevalence of HBV in cirrhosis, PLCC and chronic hepatitis were 100%, 90% and 86.7% respectively. One patient (2.7%) who was a case of PLCC tested positive for HCV antibody and this patient was positive for HBV as well.
Conclusion: HBV related liver diseases (chronic hepatitis, cirrhosis and PLCC) are prevalent in this environment despite the almost totally preventable nature of the virus. It is therefore recommended that screening and vaccination for HBV should be encouraged and that those found positive for HBV be referred to a specialist early for proper evaluation and follow up. These measures will no doubt reduce the morbidity and mortality associated with HBV infection in this environment.


Sahel Medical Journal Vol. 11 (1) 2008: pp. 20-23