Liver involvement in patients with hematologic neoplasms – single centre experience with transjugular liver biopsies

Liver involvement is common in patients with hematologic neoplasms. Despite advances in diagnostic methods, histological examination plays an irreplaceable role. Percutaneous liver biopsy is often contraindicated, and the standard approach is transjugular liver biopsy (TJLB). The aim was to evaluate our centre’s experience with TJLB in a consecutive cohort of patients with hematologic neoplasms. We performed a retrospective analysis of all patients who underwent TJLB at our institution between 1992 and 2024 because of suspected liver involvement related to a hematologic neoplasm. Biopsies were obtained with the standard aspiration technique, using access via the right internal jugular vein. A total of 93 patients (62 men, 31 women; mean age 53.3 ± 15.6 years) underwent TJLB due to suspected hematology-related liver disease. Underlying hematological diagnoses were: lymphoma (32 patients), acute or chronic leukemia (36), myelodysplastic syndrome or other chronic disorders (23) and other conditions in 2 patients. An adequate liver tissue sample was obtained in 90 patients (97%). Histology revealed infiltration by the primary hematological malignancy in 33 patients, graft-versus-host disease (GVHD) in 12, extramedullary hematopoiesis in 8, hemophagocytosis in 5, amyloid deposition in 8, toxic injury in 13 and other findings in the remaining cases. Complications: One death occurred owing to intraperitoneal bleeding (1.08%), two cases of hemothorax were recorded (2.15%), and seven minor adverse events (7.5%) were noted. TJLB demonstrated acceptable diagnostic yield with manageable complication rates in a high-risk population with hematological neoplasms. In selected indications it remains indispensable for guiding further patient management. NA