Liver & intrahepatic bile ducts
Dysplasia
Large regenerative nodule
Topic Completed: 1 February 2017
Minor changes: 1 August 2020
Revised: 25 January 2019, last major update February 2017
Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.
PubMed Search: Large regenerative nodule
Table of Contents
Definition / general | Essential features | Terminology | Clinical features | Radiology description | Gross description | Gross images | 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 August 14th, 2020.
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
Gross images
Images hosted on other servers:
Large regenerative nodules,
along with other nodule
types and carcinoma
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
Images hosted on PathOut server:
Images contributed by Naziheh Assarzadegan, M.D.:
Small cell change (10x)
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 cell change and small cell change
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
