Liver & intrahepatic bile ducts
Liver cell dysplasia

Topic Completed: 1 November 2016

Minor changes: 23 September 2020

Copyright: 2002-2021,, Inc.

PubMed search: Liver cell dysplasia[TI]

Naziheh Assarzadegan, M.D.
Raul S. Gonzalez, M.D.
Page views in 2020: 1,981
Page views in 2021 to date: 66
Cite this page: Assarzadegan N. Liver cell dysplasia. website. Accessed January 16th, 2021.
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)
  • Terms adenomatous hyperplasia and atypical adenomatous hyperplasia are no longer in use
Gross description
  • Dysplastic foci cannot be identified grossly
Microscopic (histologic) 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
Microscopic (histologic) images

Contributed by Dr. Naziheh Assarzadegan

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)

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Image 01 Image 02