State-of-the-art review on the correlations
between pathological and magnetic resonance features of cirrhotic nodules
Matteo Renzulli1*, Lorenzo Braccischi1*, Antonietta D’Errico2, Anna Pecorelli1, Nicoḷ Brandi1, Rita Golfieri1, Elisa Albertini2# and Francesco Vasuri2#
1Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna and
2Pathology Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
*MR and LB share co-authorship
#EA and FV share co-seniorship
Corresponding Author: Matteo Renzulli, Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italia. e-mail: matteo.renzulli@aosp.bo.it
Summary. Hepatocellular carcinoma (HCC) has become the second greatest cause of cancer-related mortality worldwide and the newest advancements in liver imaging have improved the diagnosis of both overt malignancies and premalignant lesions, such as cirrhotic or dysplastic nodules, which is crucial to improve overall patient survival rate and to choose the best treatment options. The role of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) has grown in the last 20 years. In particular, the introduction of hepatospecific contrast agents has strongly increased the definition of precursor nodules and detection of high-grade dysplastic nodules and early HCCs. Nevertheless, the diagnosis of liver tumours in cirrhotic patients sometimes remains challenging for radiologists, thus, in doubtful cases, biopsy and histological analysis become critical in clinical practice.
This current review briefly summarizes the history of imaging and histology for HCC, covering the newest techniques and their limits. Then, the article discusses the links between radiological and pathological characteristics of liver lesions in cirrhotic patients, by describing the multistep process of hepatocarcinogenesis. Explaining the evolution of pathologic change from cirrhotic nodules to malignancy, the list of analyzed lesions provides regenerative nodules, low-grade and high-grade dysplastic nodules, small HCC and progressed HCC, including common subtypes (steatohepatitic HCC, scirrhous HCC, macrotrabecular massive HCC) and more rare forms (clear cell HCC, chromophobe HCC, neutrophil-rich HCC, lymphocyte-rich HCC, fibrolamellar HCC). The last chapter covers the importance of the new integrated morphological-molecular classification and its association with radiological features. Histol Histopathol 37, 1151-1165 (2022)
Key words: Liver, Liver imaging, Magnetic resonance imaging, Hepatocellular carcinoma, Cirrhosis, Immunochemistry
DOI: 10.14670/HH-18-487
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©The Author(s) 2022. Open Access. This article is licensed under a Creative Commons CC-BY International License. |
