Histological and Molecular Evaluation of Liver Biopsies: A Practical and Updated Review

Abstract

Liver biopsy remains an indispensable diagnostic modality in contemporary hepatology because most classification systems and pathogenetic concepts are grounded in morphology. The diagnostic yield of a biopsy hinges on specimen adequacy and meticulous tissue processing; however, interpretation often challenges even experienced pathologists. This narrative review summarizes practical aspects of histological and molecular assessment for both clinicians and pathologists. Key topics include specimen handling, selection of ancillary stains, recognition of pivotal patterns of hepatic injury, and a systematic approach to differential diagnosis. Mastery of both histological and molecular principles is essential for accurate diagnosis, appropriate therapy, and reliable prognostication.