Indications for core needle biopsy include cardiac cirrhosis, congenital hepatic fibrosis, or cirrhosis due to vascular disorders, such as the Budd–Chiari syndrome, hereditary hemorrhagic telangiectasia, or nodular regenerative hyperplasia, as well as elevated CA 19-9 or carcinoembryonic antigen levels suggestive of intrahepatic cholangiocarcinoma or “mixed” or “combined” HCC–cholangiocarcinoma. The gene discussed is CEACAM5; the disease is intrahepatic cholangiocarcinoma.