A MACROREGENERATIVE NODULE CONTAINING MULTIPLE FOCI OF HEPATOCELLULAR-CARCINOMA IN A NONCIRRHOTIC LIVER

We report an incidental small hepatocellular carcinoma in a patient wi th chronic hepatitis C infection without cirrhosis. The existence of p ortal triads and the Meyenburg complexes within the lesion and atypica l 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 macroregene rative nodules as being precursor lesions in the development of hepato cellular carcinoma. Although they are generally thought of as being la rge cirrhotic nodules, this case suggests that they may be lesions tha t develop in the context of chronic liver disease, parallel to, but in dependently of, cirrhosis. Moreover, the development of carcinoma with in the nodule suggests that macroregenerative nodules may play a role in carcinogenesis in noncirrhotic livers.