Early hepatocellular carcinoma and dysplastic nodules

Semin Liver Dis. 2005;25(2):133-42. doi: 10.1055/s-2005-871193.


It has been established that small, equivocal nodular lesions such as dysplastic nodules (DNs) and small well-differentiated hepatocellular carcinomas (early HCCs) are frequently observed in noncancerous liver tissues resected along with HCCs and in explant cirrhotic livers. DNs are classified into low-grade DNs or high-grade DNs on the basis of cytological and architectural atypia; high-grade DNs show varying degrees of cytological or architectural atypia, or both. Early HCCs are indistinctly nodular and highly differentiated and are frequently difficult to differentiate from high-grade DNs. Although the pathological diagnosis of high-grade DNs and early HCCs is controversial, the presence of tumor cell invasion into the intratumoral portal tracts (stromal invasion) is a helpful clue for differentiating early HCC from high-grade DNs. It is highly suggested that many HCCs occurring in cirrhotic liver arise in DNs and develop to classical HCC in a multistep fashion.

Publication types

  • Review

MeSH terms

  • Carcinoma, Hepatocellular / pathology*
  • Cell Differentiation
  • Cellular Senescence
  • Disease Progression
  • Hepatocytes / pathology
  • Humans
  • Immunohistochemistry
  • Liver Cirrhosis / pathology
  • Liver Neoplasms / pathology*
  • Neoplasm Invasiveness