Damage Scores for Liver Biopsy
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| HISTOLOGY ACTIVITY INDEX (HAI – Knodell Score) | |||||||
|---|---|---|---|---|---|---|---|
| Periportal ± Bridging Necrosis | Score | Intralobular Degeneration and Focal Necrosis | Score | Portal Inflammation | Score | 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 50% of the circumference of most portal tracts) |
3 | Moderate (involvement of 1/3-2/3 of lobules or nodules) | 3 | Moderate (increased inflammatory cells in 1/3-2/3 of portal tracts) | 3 | Bridging Fibrosis (portal-portal or portal-central linkage) | 3 |
| Marked piecemeal necrosis (involves 50% 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 | Cirrhosis | 4 |
| Moderate piecemeal necrosis plus bridging necrosis | 5 | ReferenceKnodell RG, et al. | |||||
| Marked piecemeal necrosis plus bridging necrosis | 6 | ||||||
| Multilobular necrosis | 10 | ||||||
