Liver and intrahepatic bile ducts - Tumor
Liver cell dysplasia

Author: Naziheh Assarzadegan, M.D. (see Authors page)

Editor: Raul S. Gonzalez, M.D.

Revised: 21 November 2016, last major update November 2016

Copyright: (c) 2004-2016,, Inc.

PubMed search: liver cell dysplasia [title]

Cite this page: Liver cell dysplasia. website. Accessed January 19th, 2017.
Definition / General
Essential Features
  • Dysplastic features in hepatocytes that can progress to malignancy as part of a multistep sequence
  • May be incidentally discovered or seen in a discrete nodule
  • "Dysplastic foci" are incidental submillimeter microscopic lesions, in cirrhotic livers, containing dysplastic hepatocytes (Arch Pathol Lab Med 2011;135:704)
  • "Large cell change" and "small cell change" refer to morphologic changes in hepatocytes; these were formerly called "large cell dysplasia" and "small cell dysplasia"
  • "Iron free foci" are areas of hepatocytes lacking iron in a liver otherwise suffering significant iron overload; they appear to be preneoplastic (Hepatology 1993;18:1363)
  • The terms "adenomatous hyperplasia" and "atypical adenomatous hyperplasia" are no longer in use
Gross Description
  • Dysplastic foci cannot be identified grossly
Micro Description
  • Large cell change is defined as an increase in both nuclear and cytoplasmic size, preserving nuclear to cytoplasmic ratio; nuclei are hyperchromatic, pleomorphic and frequently multinucleated
  • Small cell change is defined as hepatocytes showing decreased cell volume, increased nuclear to cytoplasmic ratio, mild nuclear pleomorphism, hyperchromasia and cytoplasmic basophilia, giving the impression of nuclear crowding; this pattern is typical of high grade dysplastic nodules
Micro Images
Images hosted on PathOut server:

Courtesy of Naziheh Assarzadegan, M.D.:

Small cell change (10×)

Small cell change (40×)

Large cell change (20×)

Large cell change (40×)

Large cell change
(lower right) with
adjacent cirrhotic
nodule (upper left)

Images hosted on other servers:

Large cell change and small cell change