Ultrasonically-guided Liver Biopsy

A method is described of fine-needle aspiration biopsy of liver metastases under direct guidance by ultrasonic scanning. Comparing the results with this technique and those with liver biopsy by Menghini''s method in 18 cases, we found that it was more accurate than the usual blind method.     

Transrectal Prostatic Biopsy

Transrectal prostatic biopsy specimens were taken from 218 patients with prostatic symptoms—138 by the Franzen aspiration technique without anaesthesia as outpatients and 80 by the Silverman technique under general anaesthesia. A reliable diagnosis was obtained in 82% of the former and 95% of the latter.     

Open Lung Biopsy

Steady improvement in the diagnostic appraisal of obscure pulmonary and mediastinal disease has permitted more intelligent treatment, better prognosis, and where necessary more accurate assessment of compensability. Open lung biopsy is designed to obtain material for pathological study when there is no pleural, mediastinal, or airway lesion on which to base a working diagnosis.A study of 54 patients in whom lung biopsy was performed at the Toronto General Hospital and Weston Sanatorium is reported. A positive tissue diagnosis was obtained in approximately 75%. The procedure is considered relatively innocuous if sensible selection is exercised to exclude patients with terminal disease, particularly that associated with severe cardiorespiratory insufficiency. No major complications occurred in this series. It is concluded that open lung biopsy might reasonably receive much wider application than in the past in cases in which a definite diagnosis cannot otherwise be made.     

Bleeding After Liver Biopsy

During nine years 3,080 liver biopsies were carried out and bleeding occurred in 22 of the patients (0.7 percent). Transfusions were given to 17 of these patients and laparotomies were done to control the bleeding in six. All survived. Bleeding was evident within three hours in 19 patients, but occurred from 3 to 13 days after biopsy in the remaining three. Pain requiring analgesic medication and a fall in blood pressure were the usual indications that major bleeding had occurred. Relative contraindications to biopsy (particularly a prolonged prothrombin time) were present in 10 of the 22 bleeding patients and in only 2 of the 41 nonbleeding controls (P<0.001). We believe that some of the bleeding episodes could have been prevented with more careful attention to the indications and contraindications to biopsy, and more rigorous correction of recognized clotting abnormalities.