Liver cell dysplasia and early hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is a major world health problem. Screening and diagnosis of early lesions of HCC allows prompt treatment to improve clinical outcomes. Early lesions of HCC include premalignant lesions and small HCCs. The former consists of hepatocellular cytological changes (large cell change, small cell change and iron-free foci), dysplastic foci and dysplastic nodules (low-grade and high-grade); while the latter is subdivided into early HCC and progressed HCC. There is significant overlap in pathological and radiological features between high-grade dysplastic nodules and early HCC making a precise diagnosis demanding even among experts. Various conventional and emerging potential diagnostic markers have been evaluated in assisting pathological diagnosis of early HCC. Translation of the concept of early HCC to daily clinical practice in term of diagnosis and tumour staging is challenging to clinicians, radiologists and pathologists.