dysplastic nodule

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  • Clinical

    • associations: cirrhosis, chronic liver disease
    • size < 1.5 cm
  • Histology

    • different/stands out from background liver
    • hypercellular
    • can have unpaired arteries
    • can have iron, copper, steatosis
  • Types

    • low grade: can't really tell apart from a large regenerative nodule
    • high grade: more atypia, but doesn't make it to HCC
      • hypercellular
      • thicker plates (3 cell thick)
      • worriesome features: unpaired arteries, small cell change, pseudoglandular change, expansile subnodules
    • HCC arising in dysplastic nodule
  • Stains

    • order these stains: glypican3, HSP70, glutamine synthetase
    • early HCC acquires positivity in the above stains