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Contributed by Parmjeet S.
Randhawa, M.D.
Previous Biopsies on this Patient:
NONE
TPIS Related Resources:
Knodell Scoring
Liver Transplant Topics
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The needle biopsy is small and contains only five portal triads, but portal to portal bridging fibrosis appears to be present. There is a mild portal mononuclear infiltrate focally extending across the limiting plates. The lobules show mild mixed steatosis, multifocal sinusoidal inflammation and scattered necrotic hepatocytes. No granulomas, duct lesions, Mallory's hyaline or viral inclusions are seen. The central veins appear to be unremarkable.
| KNODELL'S HISTOLOGY ACTIVITY INDEX | ||
|---|---|---|
| Feature | RANGE | SCORE |
| Periportal and bridging necrosis | (0-10) | 1 |
| Intralobular degeneration and necrosis | (0-4) | 3 |
| Portal inflammation | (0-4) | 3 |
| Fibrosis | (0-4) | 2 |
| TOTAL | (0-22) | 9 |
The numerical scoring system of histological activity index (HAI) has been developed to grade the liver biopsies of chronic active hepatitis. This is based on four categories of periportal and bridging necrosis, intralobular degeneration and necrosis, portal inflammation and fibrosis, with total score of up to 22. This scoring system is correlated well with the severity of disease. A copy of the original paper published by American Association for the Study of Liver Disease [Hepatology 1:431 (1981)] is available at the Department of Pathology upon request.