Table 3.
Classification tool for hepatocellular lesions in cirrhotic liver. Assess each individual histological feature (as per Table 1) and go to Table 4a
| Column 1 | Column 2 | Column 3 | Column 4 |
| HCC | DN or MRN | DN | MRN |
| Vascular invasion not present | Capillarization score 3, 4, or 5 | Capillarization score 0, 1, or 2 | |
| Capsular invasion not present | Cellular atypia score 1, 2, 3, 4, or 5 | Cellular atypia score 0 | |
| Necrosis present | Necrosis not present | Reticulin loss score 1, 2, 3, 4, or 5 | Reticulin loss score 0 |
| Mitosis present | Mitosis not present | Trabecular thickness >3 | Trabecular thickness <4 |
| Capillarization score 4 or 5 | Capillarization Score 0, 1, 2 or 3 | Solitary arterioles ≥1 | Solitary arterioles <1 |
| Cellular atypia score 3, 4, or 5 | Cellular atypia score 0, 1, or 2 | Heterogeneity present | Heterogeneity absent |
| Reticulin loss score 1, 2, 3, 4, or 5 | Reticulin loss score 0 | Necrosis present | |
| Trabecular thickness>3 | Trabecular thickness<4 | Mitosis present | |
| Solitary arterioles ≥1 | Solitary arterioles<1 | ||
| Heterogeneity present | Heterogeneity absent |
3a HCC vs DN/MRN If the given lesion is not HCC according to this table, Table 3b provides guidance regarding the assignment of DN vs MRN. 3b DN vs MRN. The nodule is DN, if the number of features in the “DN, column 3” is higher than the number of the features in the “MRN, column 4” and vice versa. In case of an even balance, the nodule is regarded as DN HCC, hepatocellular carcinoma; DN, dysplastic nodule; MRN, macroregenerative nodule.