In recent years, with the popularity of liver MRI, the description “hepatic anisotropic nodules (DN) are not excluded” or “hepatic anisotropic nodules (DN) are highly probable” often appears in the report, which not only This description not only makes the patient confused, but many lay doctors may not be able to explain it either. Dysplastic nodules (DN), also known as adenomatous hyperplasia, are nodular proliferative lesions that occur in the context of cirrhosis and are important precancerous lesions of hepatocellular carcinoma. The clinical presentation is similar to cirrhosis or early small hepatocellular carcinoma. It is negative for alpha-fetoprotein (AFP) or positive at low concentrations, with a hypodense shadow on CT and an enhancing lesion in the arterial phase. According to the degree of heterogeneity of DN, it is further divided into low and high heterogeneous hyperplastic nodules. Low DN is closer to large regenerative nodules of cirrhosis; high DN is more heterogeneous and closer to hepatocellular carcinoma. In summary, the so-called heterogeneous hyperplastic nodules (DN) in the liver is a pathological change that is closer to liver cancer from imaging and pathology, but it is not liver cancer, but a precancerous lesion. What should be the management of DN is really a difficult problem in clinical practice? Especially for those who have family history of liver cancer and high risk factors for liver cancer, it is troublesome, especially for those who have been diagnosed with liver cancer, it is even more disturbing to find DN again. There are several treatment options for DN, and we will talk about them separately: ① “I would rather kill three thousand by mistake than let one go”. Many doctors and patients are inclined to adopt this treatment plan, thinking that it is not good anyway, so it is better to eliminate it early through surgery or radiofrequency ablation. The problem is that DN is not liver cancer, and these patients are basically cirrhotic, so unless it is necessary, any unnecessary surgery or radiofrequency treatment is bound to cause a certain blow to the liver and also a great financial cost. The result is likely to be more than worth the cost. ② Leave it alone for now and review it regularly. This disposition option is equally problematic! If the patient is only observed but not treated, he or she will feel that he or she is passively waiting and that there is always a “time bomb” hanging over him or her. This kind of anxiety is actually very harmful, as it will affect the patient’s mood, diet and sleep, and the state of restlessness will definitely lower immunity, and precancerous lesions will turn into cancer earlier. Moreover, patients may be inclined to intensive review due to uneasiness, while too intensive examinations, especially frequent CT examinations have been proven to be harmful to the body and can induce liver cancer. The correct treatment plan is as follows: 1. Active treatment of cirrhosis, especially for those who are HBV-DNA positive without antiviral or antiviral without HBV-DNA negative, should be actively antiviral or adjust the antiviral regimen as soon as possible. Moderate liver protection and modulation of immune therapy. It is vital to maintain a relaxed mood, good nutrition and sleep status. 2. Regular review: The review cycle is set at 3-6 months, with close monitoring of methotrexate and imaging (enhanced MRI is recommended as the first choice, and enhanced CT or ultrasonography can be used if MRI cannot be performed), while liver function and HBV-DNA tests are also necessary. The review must be done in a hospital specialized in liver disease or tumor. In case of ambiguous test results, it is recommended to consult multiple experts to avoid misjudgment. 3. Scientific TCM treatment: The principle of treatment is to support the righteousness, which can reverse some precancerous lesions by improving immunity and liver function (please refer to my article “The key of TCM treatment for liver cancer is to support the righteousness”). However, it is not recommended to take too many proprietary Chinese medicines or health supplements without clear efficacy. Chinese medicine treatment must be sought from an experienced Chinese medicine practitioner. 4. Evaluation of efficacy: After proper treatment and recuperation, if DN remains stable or shrinks in size for a long time and the general condition improves, the review interval can be moderately extended. If there is an increase in volume or accompanied by a significant increase in methemoglobin, liver cancer is likely and should be treated actively. In conclusion, the treatment of DN should neither be over-treated nor paralyzed. The key is to master a degree!