What is a liver nodule?

A liver nodule is a cell growth which forms a mass inside the liver. The nodules are easily detected by ultrasound and most are benign, although additional tests are needed to determine if they are malignant. It is possible to speak of nodule, nodular lesion or tumor indistinctly, but it is common to reserve the term nodule for masses less than 1 cm in diameter.

Symptoms

Most liver nodules do not produce symptoms and are found accidentally during tests for other unrelated health issues, usually through an abdominal ultrasound. They are sometimes found even after death in healthy livers of patients who died of other reasons.

Some nodules can cause painespecially if they are large or if they are complicated by internal bleeding in the abdominal cavity, which happens rarely. Liver enzyme blood tests are usually normal. In some cases of nodules of a certain size, alkaline phosphatase and gamma-glutamyl transpeptidase may appear slightly increased.

Diagnosis

Liver nodules are usually detected during the performance of abdominal ultrasounds. Ultrasounds cannot determine if the nodule is benign or malignant. For this, other imaging tests are performed, such as computed tomography wave magnetic resonancewhich allow to differentiate a malignant lesion by the different uptake of the contrast.

If the imaging techniques do not allow a clear diagnosis to be obtained, it is resorted to performing biopsies. Liver biopsy can be performed by percutaneous puncture. If this biopsy is not enough and it is necessary to resort to surgery, the most common thing is to proceed to the complete removal of the nodule and proceed to the diagnosis by subsequent examination.

Types

Nodules are usually classified into two large groups, regenerative nodules and dysplastic nodules:

  1. regenerative nodules: they are made up of normal hepatocytes but they have grown abnormally. They are benign in nature and can evolve into dysplastic nodules.
  2. dysplastic nodules: contain abnormal hepatocytes. They can grow to form tumors, the most common being hemangioma, hepatocellular adenoma, and focal nodular hyperplasia, all of which are benign. In some liver diseases, such as cirrhosis, they are common. Malignant liver nodules are usually of the dysplastic type.

Until the nature of the nodule is determined, no treatment regimen is usually followed. After studying the tissue, if it is determined that the nodule is a health risk, surgical removal or other treatments that are deemed appropriate depending on the case will be carried out. In the case of benign nodules, it is common to proceed to periodic surveillance.

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