| Grading Terminology | Criteria | ||||
| Grade | Descriptive | Steatosis | Hepatocyte Ballooning |
Lobular Inflammation | Portal Inflammation |
| 1 | Mild | Mainly macrovesicular, may involve up to 66% of the lobules | Occasional, Zone 3 | Scattered neutrophils, occasional mononuclear cells | None to mild |
| 2 | Moderate | Any extent, usually mixed macro- and microvesicular | "Obvious", Zone 3 | Neutrophils may be noted associated with ballooned hepatocytes, pericellular fibrosis; mild chronic inflammation may be seen | Mild to moderate |
| 3 | Severe | Typically >66% (panacinar); commonly mixed steatosis | Marked, predominantly Zone 3 | Scattered acute and chronic inflammation; neutrophils may concentrate in Zone 3 areas of ballooning and perisinusoidal fibrosis | Mild to moderate |
| Staging Terminology | ||
|---|---|---|
| Stage | Descriptive | Comments |
| 1 | Zone 3 perivenular, perisinusoidal (pericellular) fibrosis | Fibrosis at these sites may be focal or extensive |
| 2 | Stage 1 changes + periportal fibrosis | Periportal fibrosis may be focal or extensive |
| 3 | Bridging fibrosis | May be focal or extensive |
| 4 | Cirrhosis | Cirrhosis |
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Reference
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