The detection of hepatic nodules by imaging techniques in cirrhotic patients has increased and the growing consensus that these lesions may be premalignant increases their clinical importance and demands precise diagnostic criteria. The prevalence of macroscopic suspect hepatic nodule (MSHN) in cirrhotic livers was analyzed to identify macroregenerative nodule (MRN), dysplastic nodule and hepatocellular carcinoma (HCC) and to evaluate an association between MSHN and HCC. Hepatic nodules larger than 1cm and different from the surrounding nodules of the cirrhosis in color and texture were considered MSHN. Sixty-one cirrhotic liver explants were serially sectioned into 0.5 to 0.7cm slices and MSHN and protocol samples were examined histologically. Ninety-four MSHN were identified in 26 livers (histologically 11 were cirrhotic nodules, 61 MRN, 12 dysplastic nodules, and ten HCC). HCC was identified macroscopically in one liver and by light microscopy within MSHN in six other livers. The relation between HCC and MSHN, specifically MRN, was statistically significant. These findings suggest an association between MRN and MSHN with HCC in cirrhotic livers and reinforce the practical importance of histological classification of hepatic nodules in cirrhosis in order to guide the management of patients who are waiting for liver transplant or surgical treatment.
Cirrhotic liver explants; Macroregenerative nodule; Dysplasia; Hepatocellular carcinoma
