Hey JJ-
This is a chart, which you cant see but explains,
stage four being cirrhosis and
stage two only being moderate
fibrosis, if this is clear as mud I can find more.
Neil ******************************************************* Scoring Systems for Staging
of Chronic Hepatitis
*******************************************************
Various scoring systems are used to evaluate the amount
of fibrosis in chronic hepatitis.
Score Description Knodel Sciot and Desmet
(unpublished) Scheuer
0 No
fibrosis No
fibrosis None None
1 Mild
fibrosis Fibrous portal
expansion Periportal fibrous
expansion Enlarged,fibrotic
portal tracts
2 Moderate
fibrosis (blank) Porto-portal septa
(> 1 septum) Periportal or portal-portal septa,
but intact architecture
3 Severe
fibrosis Bridging
fibrosis
(portal-portal or
portal-central linkage Portocentral septa
(> 1 septum)
Fibrosis with architectural
distortion, but no
obvious cirrhosis
4 Cirrhosis Cirrhosis Cirrhosis Probable or definite
cirrhosis
From: Desmet: Hepatology
1994) 19:1513; Knodell: Hepatology
1981) 1:431; Scheuer: J Hepatology
1991) 13:372
--------------------------------------------------------------------------------
HAI (histological activity index) by Knodell
I. Periportal +/- Bridging Necrosis [Score]
A. none [ 0]
B. mild piecemeal necrosis [1]
C. moderate piecemeal necrosis (involve less than 50%
of the circumference
of most portal tracts) [3]
D. marked piecemeal necrosis (involve more athan 50%
of the circumference
of most portal tracts) [
4]
E. moderate piecemeal necrosis plus bridging necrosis plus bridging necrosis [5]
F. marked piecemeal necrosis plus bridging necrosis plus bridging necrosis [6]
G. multilobular necrosis [10]
II. Intralobular Degeneration and Focal Necrosis
A. none [0]
B. mild (acidoplhilic bodies, balooning degeneration and/or scattered foci
of hepatocellular necrosis in < 1/3
of lobules or nodules) [1]
C. moderate (involvement
of 1/3 ~ 2/3
of lobules or nodules) [3]
D. marked (involvement
of > 2/3
of lobules or nodules) [
4]
III. Portal Inflammation
A. no portal inflammation [0]
B. mild (sprinkling
of inflammatory cells in < 1/3
of portal tracts) [1]
C. moderate (increased inflammatory cells in 1/3 ~ 2/3
of portal tracts) [3]
D. marked (dense packing
of inflammatory cells in > 2/3
of portal tracts) [
4]
IV.
Fibrosis
A. no
fibrosis [0]
B. fibrous portal expansion [1]
C. bridging
fibrosis (portal-portal or portal-central linkage) [3]
D. cirrhosis [
4]
From Knodell RG et al.; Formulation and application
of a numerical scoring system for assessing histological activity in asymtomatic chronic active hepatitis. Hepatology, (1981) 1:431
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--Get Outdoors-Enjoy Life----Neil
