| Modified HAI Grading:
Necroinflammatory Scores |
|
Periportal or Periseptal Interface Hepatitis
(piecemeal necrosis)
(A) |
Score |
Confluent Necrosis
(B) |
Score |
Focal (spotty) Lytic Necrosis, Apoptosis,
and Focal Inflammation*
(C) |
Score |
Portal Inflammation
(D) |
Score |
| Absent |
0 |
Absent |
0 |
Absent |
0 |
None |
0 |
| Mild (focal, few portal areas) |
1 |
Focal confluent necrosis |
1 |
One focus or less per 10x
objective |
1 |
Mild, some or all portal areas |
1 |
| Mild/moderate (focal, most
portal areas) |
2 |
Zone 3 necrosis in some areas |
2 |
Two to four foci per 10x objective |
2 |
Moderate, some or all portal
areas |
2 |
| Moderate (continuous around
<50% of tracts or septa) |
3 |
Zone 3 necrosis in most areas |
3 |
Five to ten foci per 10x objective |
3 |
Moderate/marked, all portal
areas |
3 |
| Severe (continuous around
>50% of tracts or septa) |
4 |
Zone 3 necrosis + occasional
portal-central (P-C) bridging |
4 |
More than ten foci per 10x
objective |
4 |
Marked, all portal areas |
4 |
|
|
Zone 3 necrosis + multiple
P-C bridging |
5 |
References
- Ishak K, et al. Histological grading and staging of
chronic hepatitis. J Hepato/1995;22:696-699.
- Knodell RG, et al. Formulation and application of
a numerical scoring system for assessing histological activity in asymptomatic
chronic active hepatitis. Hepatology
1981;1(5):431-5
|
|
Modified Staging
Chart
|
Scoring Chart |
|
| Panacinar or multiacinar necrosis |
6 |
|
Total Modified HAI = __/18 |
|
Does not include diffuse sinusoidal
infiltration by inflammatory cells.
|
- Additional features which should be noted but not
scored:
-
- Bile Duct inflammation & damage
- Lymphoid Follicles
- Steatosis, mild, moderate or marked
- Hepatocellular dysplasia, small or large cell
- Adenomatous hyperplasia
- Iron or copper overload
- Intracellular inclusions
|
Immunohistochemical findings:
- <ä2></ä2>
-
Information on viral antigens, lymphocyte subsets or other features,
when available, should be recorded and may be semi-quantitatively
expressed
|
|
