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Grading & Scoring Liver Damage

Knodell Histological Activity Index

  1. Periportal +/-bridging necrosis [Score]
    1. none [ 0]
    2. mild piecemeal necrosis [1]
    3. moderate piecemeal necrosis (involve less than 50% of the circumference of most portal tracts) [3]
    4. marked piecemeal necrosis (involve more athan 50% of the circumference of most portal tracts) [4]
    5. moderate piecemeal necrosis plus bridging necrosis plus bridging necrosis [5]
    6. marked piecemeal necrosis plus bridging necrosis plus bridging necrosis [6]
    7. multilobular necrosis [10]
  2. intralobular degeneration and focal necrosis
    1. none [0]
    2. mild (acidoplhilic bodies, balooning degeneration and/or scattered foci of hepatocellular necrosis in less than 1/3 of lobules or nodules) [1]
    3. moderate (involvement of 1/3 ~ 2/3 of lobules or nodules) [3]
    4. marked (involvement of > 2/3 of lobules or nodules) [4]
  3. portal inflammation
    1. no portal inflammation [0]
    2. mild (sprinkling of inflammatory cells in less than 1/3 of portal tracts) [1]
    3. moderate (increased inflammatory cells in 1/3 ~ 2/3 of portal tracts) [3]
    4. marked (dense packing of inflammatory cells in > 2/3 of portal tracts) [4]
  4. fibrosis
    1. no fibrosis [0]
    2. fibrous portal expansion [1]
    3. bridging fibrosis (portal-portal or portal-central linkage) [3]
    4. cirrhosis [4]