Semin Liver Dis 2005; 25(2): 133-142
DOI: 10.1055/s-2005-871193
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Early Hepatocellular Carcinoma and Dysplastic Nodules

Masamichi Kojiro1 , Tania Roskams2
  • 1Professor and Chairman, Department of Pathology, Kurume University School of Medicine, Kurume-shi, Japan
  • 2Professor and Chairperson, Department of Pathology, University of Leuven, Leuven, Belgium
Further Information

Publication History

Publication Date:
25 May 2005 (online)


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.


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Masamichi KojiroM.D. 

Department of Pathology, Kurume University School of Medicine

67 Asahi-machi, Kurume-shi 830-0011, Japan