Is the abnormal enhancement nodule liver cancer? It is not liver cancer, but precancerous lesions

In recent years, with the popularity of liver magnetic resonance imaging (MRI) examinations, the following descriptions often appear in reports: "Hepatic dysplastic nodules (DN) cannot be ruled out" or "Hepatic dysplastic nodules (DN) are likely to occur." Such descriptions not only confuse patients, but also many non-professional doctors may not be able to explain them clearly.

The so-called abnormal enhancement lesions are also called adenomatous hyperplasia, which is a nodular hyperplastic lesion that occurs in the context of liver cirrhosis and is an important precancerous lesion of hepatocellular carcinoma. The clinical manifestations are similar to those of liver cirrhosis or early small liver cancer. Alpha-fetoprotein (AFP) is negative or low-concentration positive, and CT examination shows low-density shadows, and the lesions are enhanced in the arterial phase.

According to the degree of atypia of DN, it is divided into low-grade and high-grade dysplastic nodules. Low-grade DN is closer to the large regenerative nodules in cirrhosis; high-grade DN has a higher atypia and is closer to liver cancer.

To sum up: the so-called dysplastic nodule (DN) of the liver is a pathological change that is close to liver cancer in terms of imaging and pathology, but it is not liver cancer, but a precancerous lesion.

How to deal with DN is indeed a difficult problem in clinical practice. It is especially troublesome for people with a family history of liver cancer or high-risk factors for liver cancer. Especially for patients who have been diagnosed with liver cancer, it is even more troubling to find DN during another examination. This is like the "boot hanging over the head" in the crosstalk, which is always disturbing.

There are several solutions for DN. Let's talk about them one by one:

"It is better to kill three thousand by mistake than to let one go." Many doctors and patients tend to take this approach, thinking that since it is not a good thing anyway, it is better to eliminate it as soon as possible through surgery or radiofrequency ablation. This opinion seems to make sense, but the problem is that DN is not liver cancer, and these patients are basically patients with liver cirrhosis. Unless necessary, any unnecessary surgery or radiofrequency treatment will inevitably cause a certain amount of damage to the liver, and will also inevitably cause a great economic cost. The result is likely to be more harm than good.