Hepatic siderotic nodules

Hepatic siderotic nodules are a type of regenerative nodule formed in a cirrhotic liver. They occur in hepatic hemosiderosis. The nodules have an increased iron content compared with other regenerative nodules. They may be non-dysplastic or dysplastic.


The reason why these nodules concentrate iron is uncertain, but it is attributed to differential iron metabolism in the nodule's cell population from differential transferrin expression . Stainable iron occurs in approximately 25% of all regenerative nodules . Of note, some prefer the term "iron-rich" nodule since the term "siderotic" may have a different meaning in pathology.

Radiographic features

  • nodules are potentially hyperattenuating, but the amount of hyperattenuation may be slight, and the finding is non-specific
  • moderate to marked T2/T2* hypointensity due to the T2 shortening effect of iron
  • may be T1 hypo-, iso-, or hyperintense
  • increased hypointensity on the second echo of an in- and out-of-phase sequence

Imaging cannot reliably differentiate between non-dysplastic or dysplastic siderotic nodules. A siderotic nodule's risk for hepatocellular carcinoma can be classified using LI-RADS. A "probably benign" siderotic nodule fulfills the criteria for an LR2 cirrhosis-associated nodule.

See also