Primary liver cancer is the fifth most common cancer. High grade dysplastic nodule (HGDN) shows at least moderate cytological or architectural atypia that approaches but does not quite reach the levels of hepatocellular carcinoma (HCC). Stromal invasion was recognized as the most important finding for the diagnosis of early HCCs. Stromal invasion must be differentiated from pseudoinvasion. Aims: This work aimed to draw a diagnostic line between dysplasia and carcinoma in post hepatitic liver cirrhosis for early detection that achieves long-term survival for HCC patients. Methods: Data were collected from latest available editions of well-known general surgical pathology textbooks including Rosai and Ackerman’s Surgical Pathology (2011), Sternberg’s Diagnostic Surgical Pathology (2010), and Pathology and Genetics; Tumors of Digestive System (2001). Visiting sites on the internet to collect and analyze researches concerned with the aim of the current study within a scope including the last 10 years, randomized controlled studies and meta-analysis. Results: The differentiation between HGDNs and well differentiated HCC is often difficult and stromal invasion is the most important finding used for this differentiation. Pseudoinvasion resembles stromal invasion and must be excluded. Conclusion: Several criteria are helpful for differentiation of stromal invasion from pseudoinvasion include: Macroscopic and panoramic views of the nodule, amount of fibrous components of the stroma, continuity to vascular invasion, loss of reticulin fibers and cytokeratin 7/19 immunostaining. Application of individual immunochemical marker does not seem to be very helpful in diagnosing well differentiated HCC but the application of more than one marker raises the overall accuracy