A macroregenerative nodule containing multiple foci of hepatocellular carcinoma in a noncirrhotic liver.
We report an incidental small hepatocellular carcinoma in a patient with chronic hepatitis C infection without cirrhosis. The existence of portal triads and the Meyenburg complexes within the lesion and atypical subnodules suggests that the carcinoma has arisen in the context of a macroregenerative nodule rather than the whole nodule being an early, spreading carcinoma. A growing body of evidence supports macroregenerative nodules as being precursor lesions in the development of hepatocellular carcinoma. Although they are generally thought of as being large cirrhotic nodules, this case suggests that they may be lesions that develop in the context of chronic liver disease, parallel to, but independently of, cirrhosis. Moreover, the development of carcinoma within the nodule suggests that macroregenerative nodules may play a role in carcinogenesis in noncirrhotic livers.
Lillian and Henry M. Stratton-Hans Popper Department of Pathology, Mount Sinai School of Medicine, City University of New York, New York 10029.
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Theise
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Lapook
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Thung
D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery; D002908:Chronic Disease; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D007150:Immunohistochemistry; D008103:Liver Cirrhosis / Q000473:pathology; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D008297:Male