Kojiro Masamichi, Roskams Tania
Department of Pathology, Kurume University School of Medicine, Kurume-shi 830-0011, Japan.
Semin Liver Dis. 2005;25(2):133-42. doi: 10.1055/s-2005-871193.
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.
已经确定，在与肝细胞癌（HCC）一起切除的非癌性肝组织以及移植的肝硬化肝脏中，经常观察到小的、不明确的结节性病变，如发育异常结节（DNs）和小的高分化肝细胞癌（早期HCC）。DNs根据细胞学和结构异型性分为低级别DNs或高级别DNs；高级别DNs表现出不同程度的细胞学或结构异型性，或两者皆有。早期HCC结节不明显且分化程度高，常常难以与高级别DNs区分开来。尽管高级别DNs和早期HCC的病理诊断存在争议，但肿瘤细胞侵入瘤内门静脉分支（间质浸润）的存在是区分早期HCC和高级别DNs的有用线索。强烈提示，许多发生在肝硬化肝脏中的HCC起源于DNs，并以多步骤方式发展为典型的HCC。
