HCC Part 4: Hepatocarcinogenesis: Cirrhotic nodules and dysplastic nodules:

 HCC Part 4: Hepatocarcinogenesis:  Cirrhotic nodules and dysplastic nodules:

      

Fig. Case 1 is a MRI, which demonstrates a probable dysplastic nodule,  that is hypointense on T2 W FS images, hyperintense on T1 W FS images and does not show enhancement on subtracted post contrast images. 

Fig. Case 2 is a post contrast CT Scan that demonstrates regenerating nodules, best seen on the venous or delayed images. These nodules do show any enhancement arterial phase. 

P.S: Cirrhotic nodules can also appear hyperintense on T1 W  FS images

Pathological Types:

1. Cirrhotic nodule: called as regenerating nodules. They are benign, lack of clonal features histologically and the cells are phenotypically normal. 

2. Dysplastic Foci: Microscopic lesion 

2. Dysplastic Nodule: Nodular lesions, 1-1.5 cm in diameter. There is cytologic & architectural atypia. 

3. Low grade dysplastic Nodule: Unpaired arteries & clone like population(Accumulation of copper, iron or fat, more than the liver parenchyma). 

4. high grade dysplastic Nodule: Resemble well differentiated HCCs. Cellular atypia is insufficient to to establish HCC diagnosis. 

5. Nodule within nodule: HCC arising in high grade dysplasia

Prepared by Dr. Sharad Maheshwari

28.7.2023

Updated: 

References:

https://pubs.rsna.org/doi/epdf/10.1148/radiol.14132361