Original articles

Vol. 117: Issue 2 - April 2025

Biopsy in chronic liver disease: proposal for a shared path between clinicians and pathologists

Authors

Andrea Baiocchini , Maria Conti , Daniela Fanni , Francesca Romana Ponziani , Giuliano Alagna , Clara Balsano , Simone Carotti , Antonio Cossu , Guido Delle Monache , Shirin Demma , Maria Cristina Giustiniani , Vito Gomes , Cristina Manieli , Alessandra Moretti , Teresa Musarra , Valeria Pace Palitti , Giuseppe Perrone , Chiara Taffon , Francesca Terracciani , Umberto Vespasiani-Gentilucci , Teresa Zolfino , Giulia d'Amati

Key words: Chronic liver diseases, liver biopsy, diagnostic pathway, lean management
Publication Date: 2025-05-21

Abstract

Introduction. Liver biopsy is fundamental for characterizing chronic liver disease. Effective communication between specialists during the diagnostic process is crucial. This project aims to outline a diagnostic path shared by clinicians and pathologists, and to propose practical solutions at different stages of the diagnostic work-up, from clinical suspicion to the histology report in patients with chronic liver diseases.
Methods. A panel of experts, within the methodological framework of lean management, joined two rounds of discussion sharing their professional experiences. They reached an agreement on the essential phases and actions of the diagnostic process, and built a shared diagnostic workflow.
Results. The panel agreed on the importance of a standardized form to be filled with all relevant clinical and laboratory data to ensure the flow of information between the clinician and the pathologist. Further decisions were reached on the following practical issues: the advantage of performing liver biopsies in dedicated centers, the need for homogeneous procedures, and the minimum quality standards in all phases, including reporting. Finally, the panel agreed on the usefulness of digital pathology to exchange observations and opinions and to create a territorial network to discuss challenging cases.
Conclusion. Sharing a diagnostic path between the pathologist and the clinician can be a powerful tool to improve both the timing and accuracy of the histology report.

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Authors

Andrea Baiocchini - Department of Pathology, San Camillo Forlanini Hospital, Rome, Italy

Maria Conti - SC Medicina Interna, AOU of Cagliari, Cagliari, Italy

Daniela Fanni - Department of Medical Sciences and Public Health, University of Cagliari, Unit of Pathology, AOU of Cagliari, Cagliari, Italy

Francesca Romana Ponziani - Liver Unit, Centro Malattie Apparato Digerente - CEMAD, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy

Giuliano Alagna - SSD di Epatologia, Ospedale SS. Annunziata, Sassari, Italy

Clara Balsano - Geriatric Unit, Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy; F. Balsano Foundation, Rome, Italy

Simone Carotti - Microscopic and Ultrastructural Anatomy Research Unit, Department of Medicine and Surgery, Università Campus Bio-Medico of Rome, Rome, Italy; Predictive Molecular Diagnostics, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy

Antonio Cossu - Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy

Guido Delle Monache - Department of Internal Medicine, Ospedale S. Massimo di Penne, Pescara, Italy

Shirin Demma - Hepatology Unit, San Camillo Forlanini Hospital, Rome, Italy; UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London, UK

Maria Cristina Giustiniani - Department of Pathology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy

Vito Gomes - Department of Pathology, San Filippo Neri Hospital, Rome, Italy

Cristina Manieli - UOC Anatomia Patologica, P.O. San Michele, ARNAS G. Brotzu, Cagliari, Italy

Alessandra Moretti - UOC Anatomia Patologica, P.O. San Michele, ARNAS G. Brotzu, Cagliari, Italy

Teresa Musarra - Department of Pathology, San Camillo Forlanini Hospital, Rome, Italy; 2 SC Medicina Interna, AOU of Cagliari, Cagliari, Italy

Valeria Pace Palitti - Internal Medicine Unit, Santo Spirito Hospital, Pescara, Italy

Giuseppe Perrone - Operative Research Unit of Anatomical Pathology, Fondazione Policlinico Universitario Campus Bio-Medico of Rome, Rome Italy; Research Unit of Anatomical Pathology, Department of Medicine and Surgery, Università Campus Bio-Medico of Rome, Rome Italy

Chiara Taffon - Operative Research Unit of Anatomical Pathology, Fondazione Policlinico Universitario Campus Bio-Medico of Rome, Rome Italy; Research Unit of Anatomical Pathology, Department of Medicine and Surgery, Università Campus Bio-Medico of Rome, Rome Italy

Francesca Terracciani - Unit of Clinical Medicine and Hepatology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy; Research Unit of Hepatology, Università Campus Bio-Medico of Rome, Rome, Italy

Umberto Vespasiani-Gentilucci - Unit of Clinical Medicine and Hepatology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy; Research Unit of Hepatology, Università Campus Bio-Medico of Rome, Rome, Italy

Teresa Zolfino - SC Gastroenterologia, ARNAS G. Brotzu, PO San Michele, Cagliari, Italy

Giulia d'Amati - Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy

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Copyright (c) 2025 Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology

How to Cite
Baiocchini, A., Conti, M., Fanni, D., Ponziani, F. R., Alagna, G., Balsano, C., Carotti, S., Cossu, A., Delle Monache, G., Demma, S., Giustiniani, M. C., Gomes, V., Manieli, C., Moretti, A., Musarra, T., Pace Palitti, V., Perrone, G., Taffon, C., Terracciani, F., Vespasiani-Gentilucci, U., Zolfino, T., & d’Amati, G. (2025). Biopsy in chronic liver disease: proposal for a shared path between clinicians and pathologists. Pathologica - Journal of the Italian Society of Anatomic Pathology and Diagnostic Cytopathology, 117(2). Retrieved from https://www.pathologica.it/article/view/1349
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