Dysplastic liver nodules

Dysplastic liver nodules are focal nodular regions (≥ 1 mm) without definite evidence of malignancy.

They have been found in cirrhotic patients with a prevalence of 14% (size >1.0 cm) to 37% (size >0.5 cm) 2.

Dysplasia indicates:

  • nuclear atypia
  • increased fat or glycogen in the cluster of dysplastic cells
Associations
Classification

They are broadly divided as 2,4:

Ultrasound

Cirrhotic changes are present but the nodules may not be visualised on ultrasound. Few cases have shown hypo- and hyperechoic nodules and the echogenicity relates to the fat content in the nodule.

CT

Usually hypoattenuating, however they may be iso- or hyperattenuating to the hepatic parenchyma.

  • contrast: they may show early arterial uptake but the contrast does not wash out on delayed phase (unlike HCC)
MRI
  • T1: high, low, or homogeneous intensity
  • in and out phase: shows fat accumulation
  • T2: iso- to hypointense
  • contrast studies
    • T1 C+ (Gd)
      • high grade nodules show early contrast enhancement without washout on delayed phase
    • T2* C+ (SPIO)
      • low grade nodules appear hypointense 13

They are considered premalignant and hence follow-up is necessary. Percutaneous ablation therapy can be considered 9.

There can be some imaging overlap with hepatocellular carcinoma.

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Article information

rID: 18138
Synonyms or Alternate Spellings:
  • Dysplastic hepatic nodules
  • Dysplastic liver nodules
  • Dysplastic nodules in the liver
  • Dysplastic hepatic nodule

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