Liver & intrahepatic bile ducts
Dysplasia
Large regenerative nodule
Topic Completed: 1 February 2017
Minor changes: 23 September 2020
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PubMed Search: Large regenerative nodule
Table of Contents
Definition / general | Essential features | Terminology | Clinical features | Radiology description | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosisCite this page: Assarzadegan N. Large regenerative nodule. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/livertumorlargeregenerativenodule.html. Accessed January 24th, 2021.
Definition / general
- Benign liver lesion frequently seen in Budd-Chiari syndrome and less commonly in other vascular disorders of the liver or systemic conditions such as autoimmune disease, myeloproliferative disorders and lymphoproliferative disorders (Radiographics 2002;22:847)
Essential features
- Low grade regenerative hepatocellular nodule that often arises in the setting of flow abnormalities
- Low malignant potential
Terminology
- Also known as benign regenerative nodule
Clinical features
- Low malignant potential (Hepatology 1990;12:592, Hepatol Int 2015;9:330)
- Often stabilize or disappear over time
Radiology description
- Predominantly isointense or hypointense relative to background liver on T2 weighted images
Gross description
- Multiple, well circumscribed, round lesions
- Typically 0.5 - 4.0 cm
Microscopic (histologic) description
- Nodules of hyperplastic hepatocytes arranged in thickened hepatic plates
- No distinctive cytoarchitectural features (J Hepatol 2003;39:208)
- Entrapped portal tracts often present
- Surrounding parenchyma shows atrophy and congestion and may undergo fibrosis
Microscopic (histologic) images
Contributed by Naziheh Assarzadegan, M.D.
Small cell change (10x)
Small cell change (40x)
Large cell change (20x)
Large cell change (40x)
Large cell change
(lower right) with
adjacent cirrhotic
nodule (upper left)
Images hosted on other servers:
Large regenerative
nodule in a patient with
Budd-Chiari syndrome
Differential diagnosis
- Low grade dysplastic nodule: similar to slightly higher malignant potential
- Mild increase in cellularity, with occasional large cell change
- Macroregenerative nodule: similar malignant potential
- Generally occurs in cirrhosis
- Similar if not identical by morphology
