Knodell score (histology activity index score) of liver biopsy specimens for necrosis, inflammation, and fibrosis*

I. Periportal± bridging necrosis	Score	II. Intralobular degeneration and focal necrosis¶	Score	III. Portal inflammation	Score	IV. Fibrosis	Score
None	0	None	0	No portal inflammation	0	No fibrosis	0
Mild piecemeal necrosis	1	Mild (acidophilic bodies, ballooning degeneration and/or scattered foci of hepatocellular necrosis in <1/3 of lobules or nodules	1	Mild (sprinkling of inflammatory cells in <1/3 of portal tracts)	1	Fibrous portal expansion	1
Moderate piecemeal necrosis (involves less than 50 percent of the circumference of most portal tracts)	3	Moderate (involvement of 1/3 to 2/3 of lobules or nodules)	3	Moderate (increased inflammatory cells in 1/3 to 2/3 of portal tracts)	3	Bridging fiborisis (portal-portal or portal-central linkage)	3
Marked piecemeal necrosis (involves more than 50 percent of the circumference of most portal tracts)	4	Marked (involvement of >2/3 of lobules or nodules)	4	Marked (dense packing of inflammatory cells in >2/3 of portal tracts)	4	CirrhosisΔ	4
Moderate piecemeal necrosis plus bridging necrosis◊	5
Marked piecemeal necrosis plus bridging necrosis◊	6
Multilobular necrosis§	10

* The histology activity index score is the combined scores for necrosis, inflammation, and fibrosis.
¶ Degeneration-acidophilic bodies, ballooning; focal necrosis-scattered foci of hepatocellular necrosis.
Δ Loss of normal hepatic lobular architecture with fibrous septae separating and surrounding nodules.
◊ Bridging is defined as ≥2 bridges in the liver biopsy specimen; no distinction is made between portal-portal and portal-central linkage.
§ Two or more contiguous lobules with panlobular necrosis.

Adapted from Knodell RG, et al. Hepatology 1981; 1:431.

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خرید پکیج

Knodell score (histology activity index score) of liver biopsy specimens for necrosis, inflammation, and fibrosis*