Dysplastic nodules

These are a type of preneoplastic lesions associated with cirrhosis and are thought to be pre-HCC lesions.

• Preneoplastic lesions can be divided into:
  • Microscopic dysplastic foci
  • Macroscopic dysplastic nodules (DNs)
• Microscopic dysplastic foci
  • Lesions made of dysplastic hepatocytes < 1 mm in size and occur in chronic liver disease, particularly cirrhosis
• Dysplastic nodules
  • Nodular regions < 2 cm in diameter with dysplasia but without definite histological criteria of malignancy.
    • Low grade DNs
      • <1 cm in diameter, slightly yellowish and have a very low probability of becoming malignant.
    • High grade DNs
      • Less common
      • Slightly larger nodules (up to 2 cm)
      • Characterised by increased cell density with irregular thin-trabecular pattern and occasionally unpaired arteries.
      • May be difficult to differentiate from highly differentiated HCC, and may contain foci of well-differentiated HCC therefore considered as precancerous and 1/3 become malignant.