Liver and intrahepatic bile ducts - tumor
Large regenerative nodule

Author: Naziheh Assarzadegan, M.D. (see Authors page)
Editor: Raul S. Gonzalez, M.D.

Revised: 24 February 2017, last major update February 2017

Copyright: (c) 2003-2017,, Inc.

PubMed Search: large regenerative nodule
Cite this page: Large regenerative nodule. website. Accessed October 21st, 2017.
Definition / general
  • Benign liver lesion frequently seen in Budd-Chiari syndrome and less commonly in other vascular disorders of the liver or systemic conditions such as autoimmune disease, myeloproliferative disorders and lymphoproliferative disorders (Radiographics 2002;22:847)
Essential features
  • Low grade regenerative hepatocellular nodule that often arises in the setting of flow abnormalities
  • Low malignant potential
  • Also known as benign regenerative nodule
Clinical features
Radiology description
  • Predominantly isointense or hypointense relative to background liver on T2 weighted images
Gross description
  • Multiple, well circumscribed, round lesions
  • Typically 0.5 - 4.0 cm
Gross images

Images hosted on other servers:

Large regenerative nodules,
along with other nodule
types and carcinoma

Microscopic (histologic) description
  • Nodules of hyperplastic hepatocytes arranged in thickened hepatic plates
  • No distinctive cytoarchitectural features (J Hepatol 2003;39:208)
  • Entrapped portal tracts often present
  • Surrounding parenchyma shows atrophy and congestion and may undergo fibrosis
Microscopic (histologic) images

Images hosted on PathOut server:

Contributed by Naziheh Assarzadegan, M.D.:

Small cell change (10×)

Small cell change (40×)

Large cell change (20×)

Large cell change (40×)

Large cell change
(lower right) with
adjacent cirrhotic
nodule (upper left)

Images hosted on other servers:

Large cell change and small cell change

Large regenerative
nodule in a patient with
Budd-Chiari syndrome

Differential diagnosis
  • Low grade dysplastic nodule: similar to slightly higher malignant potential
    • Mild increase in cellularity, with occasional large cell change
  • Macroregenerative nodule: similar malignant potential
    • Generally occurs in cirrhosis
    • Similar if not identical by morphology