Looking for large-cell dysplasia in liver needle biopsies how and why?

liver large cell dysplasia (LCD) is identifiable only at the microscopic le vel as foci of large hepatocytes with pleomorphic hyperchromatic nuclei and prominent nucleoli. LCD is mainly observed in cirrhotic livers, on surgical specimens, within m acroregenerative nodules or low grade dysplastic nodules bur also on liver needle biopsies. For needle biopsies, the prevalence of LCD ranges between 15% and 20%. in case of associated hepatocellular carcinoma, the prevalence is around 40%. LCD B more frequent in hepatitis B virus-induced liver cirr hosis than in cirrhosis related to other causes. Two prospective studies showed that LCD Is a predictive factor for the occu rrence of hepatocellular carcinema in cirrhotic patients. Nevertheless ICD is probably not a precancerous lesion, dysplastic hepatocytes are biologica lly senescent polyploid cells unable to carry out normal cell division. Dia gnosis of LCD on liver needle biopsy is indicative ofr the presence of larg e and numerous foci of LCD within the whole parenchya and allows consequent ly to select cirrhosis associated with advanced liver cell secescence, i.e. cirrhosis in which multistep genetic alterations of liver cell carcinogene sis could have happened with the greatest probability. Therefore pathologists have to identify and indicate the presence of LCD in the reports a liver needle biopsies.