Liver biopsy is indicated in two general clinical scenarios. The first scenario occurs when a diffuse liver disease is suspected, typically after a patient has abnormal liver function tests. In this instance, a nontargeted or random biopsy is performed to obtain a sample of tissue for determination of severity of diffuse liver disease. Random biopsy may also be used to monitor effectiveness of treatment, or for post-transplant monitoring. As these cases require histologic assessment, cytologic assessment is generally not indicated. Conversely, when a targeted liver biopsy is ordered to diagnose a focal liver mass or abnormality that cannot otherwise be characterized, cytology is frequently utilized as a first line diagnostic test.
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