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Volume 115, Issue 5, Pages 1216-1222 (November 1998) Histological features predicting malignant transformation of nonmalignant hepatocellular nodules: A prospective study Shuichi Terasaki, Shuichi Kaneko, Kenichi Kobayashi, Akitaka Nonomura, Yasuni Nakanuma Gastroenterology Volume 115, Issue 5, Pages 1216-1222 (November 1998) DOI: 10.1016/S0016-5085(98)70093-9 Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 1 Histological parameters shown in nodules. (A) Small cell dysplasia (arrows), (B) large cell dysplasia (arrows), (C) clear cell change of the hepatocytes (arrows), (D) nuclear deviation toward the sinusoids, (E) fatty change of the hepatocytes, and (F) reduction of reticulin fiber (arrows) (A–E, H&E; F, reticulin stain; original magnification: A–E, 190×; and F, 120×). Gastroenterology 1998 115, 1216-1222DOI: (10.1016/S0016-5085(98)70093-9) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 1 Histological parameters shown in nodules. (A) Small cell dysplasia (arrows), (B) large cell dysplasia (arrows), (C) clear cell change of the hepatocytes (arrows), (D) nuclear deviation toward the sinusoids, (E) fatty change of the hepatocytes, and (F) reduction of reticulin fiber (arrows) (A–E, H&E; F, reticulin stain; original magnification: A–E, 190×; and F, 120×). Gastroenterology 1998 115, 1216-1222DOI: (10.1016/S0016-5085(98)70093-9) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 1 Histological parameters shown in nodules. (A) Small cell dysplasia (arrows), (B) large cell dysplasia (arrows), (C) clear cell change of the hepatocytes (arrows), (D) nuclear deviation toward the sinusoids, (E) fatty change of the hepatocytes, and (F) reduction of reticulin fiber (arrows) (A–E, H&E; F, reticulin stain; original magnification: A–E, 190×; and F, 120×). Gastroenterology 1998 115, 1216-1222DOI: (10.1016/S0016-5085(98)70093-9) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 1 Histological parameters shown in nodules. (A) Small cell dysplasia (arrows), (B) large cell dysplasia (arrows), (C) clear cell change of the hepatocytes (arrows), (D) nuclear deviation toward the sinusoids, (E) fatty change of the hepatocytes, and (F) reduction of reticulin fiber (arrows) (A–E, H&E; F, reticulin stain; original magnification: A–E, 190×; and F, 120×). Gastroenterology 1998 115, 1216-1222DOI: (10.1016/S0016-5085(98)70093-9) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 1 Histological parameters shown in nodules. (A) Small cell dysplasia (arrows), (B) large cell dysplasia (arrows), (C) clear cell change of the hepatocytes (arrows), (D) nuclear deviation toward the sinusoids, (E) fatty change of the hepatocytes, and (F) reduction of reticulin fiber (arrows) (A–E, H&E; F, reticulin stain; original magnification: A–E, 190×; and F, 120×). Gastroenterology 1998 115, 1216-1222DOI: (10.1016/S0016-5085(98)70093-9) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 1 Histological parameters shown in nodules. (A) Small cell dysplasia (arrows), (B) large cell dysplasia (arrows), (C) clear cell change of the hepatocytes (arrows), (D) nuclear deviation toward the sinusoids, (E) fatty change of the hepatocytes, and (F) reduction of reticulin fiber (arrows) (A–E, H&E; F, reticulin stain; original magnification: A–E, 190×; and F, 120×). Gastroenterology 1998 115, 1216-1222DOI: (10.1016/S0016-5085(98)70093-9) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 2 Histological findings of nodule 1. (A) Initial biopsy specimen. The nodule was hypoechoic and 13 mm in diameter. A mild increase in nuclear density, small cell dysplasia, and clear cell change of the hepatocytes can be seen (H&E). (B) Second biopsy performed 6 months after the first biopsy. The nodule remained unchanged in echogenicity and size. It was diagnosed as a well-differentiated HCC. Nuclear hyperchromasia, marked increase of nuclear density, and trabecular pattern can be seen (H&E) (original magnification: A and B, 190×). Gastroenterology 1998 115, 1216-1222DOI: (10.1016/S0016-5085(98)70093-9) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 2 Histological findings of nodule 1. (A) Initial biopsy specimen. The nodule was hypoechoic and 13 mm in diameter. A mild increase in nuclear density, small cell dysplasia, and clear cell change of the hepatocytes can be seen (H&E). (B) Second biopsy performed 6 months after the first biopsy. The nodule remained unchanged in echogenicity and size. It was diagnosed as a well-differentiated HCC. Nuclear hyperchromasia, marked increase of nuclear density, and trabecular pattern can be seen (H&E) (original magnification: A and B, 190×). Gastroenterology 1998 115, 1216-1222DOI: (10.1016/S0016-5085(98)70093-9) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 3 Histological findings of nodule 3. (A) Initial biopsy specimen. The nodule is hyperechoic and 10 mm in diameter. It was diagnosed as a borderline nodule. A mild increase in nuclear density and clear cell and macrovesicular fatty changes of some hepatocytes can be seen (H&E). (B) Second biopsy specimen taken 14 months after the first biopsy. The hyperechoic nodule is enlarged to 17 mm in diameter. It was diagnosed as a well-differentiated HCC. Marked nuclear crowding, nuclear atypia, and microacinar formation can be seen (H&E) (original magnification: A and B, 190×). Gastroenterology 1998 115, 1216-1222DOI: (10.1016/S0016-5085(98)70093-9) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 3 Histological findings of nodule 3. (A) Initial biopsy specimen. The nodule is hyperechoic and 10 mm in diameter. It was diagnosed as a borderline nodule. A mild increase in nuclear density and clear cell and macrovesicular fatty changes of some hepatocytes can be seen (H&E). (B) Second biopsy specimen taken 14 months after the first biopsy. The hyperechoic nodule is enlarged to 17 mm in diameter. It was diagnosed as a well-differentiated HCC. Marked nuclear crowding, nuclear atypia, and microacinar formation can be seen (H&E) (original magnification: A and B, 190×). Gastroenterology 1998 115, 1216-1222DOI: (10.1016/S0016-5085(98)70093-9) Copyright © 1998 American Gastroenterological Association Terms and Conditions