For professionals:

• I. Periportal +/-bridging necrosis [Score]
  • A. none [ 0]

  • B. mild piecemeal necrosis [1]

  • C. moderate piecemeal necrosis (involve less than 50% of the circumference of most portal tracts) [3]

  • D. marked piecemeal necrosis (involve more than 50% of the circumference of most portal tracts) [4]

  • E. moderate piecemeal necrosis plus bridging necrosis [5]

  • F. marked piecemeal necrosis plus bridging necrosis [6]

  • G. multilobular necrosis [10]

• II. intralobular degeneration and focal necrosis
  • A. none [0]

  • B. mild (acidoplhilic bodies, balooning degeneration and/or scattered foci of hepatocellular necrosis in < 1/3 of lobules or nodules) [1]

  • C. moderate (involvement of 1/3 ~ 2/3 of lobules or nodules) [3]

  • D. marked (involvement of > 2/3 of lobules or nodules) [4]

• III. portal inflammation
  • A. no portal inflammation [0]

  • B. mild (sprinkling of inflammatory cells in < 1/3 of portal tracts) [1]

  • C. moderate (increased inflammatory cells in 1/3 ~ 2/3 of portal tracts) [3]

  • D. marked (dense packing of inflammatory cells in > 2/3 of portal tracts) [4]

• IV. fibrosis
  • A. no fibrosis [0]

  • B. fibrous portal expansion [1]

  • C. bridging fibrosis (portal-portal or portal-central linkage) [3]

  • D. cirrhosis [4]

{From Knodell RG et al.; Formulation and application of a numerical scoring system for assessing histological activity in asymtomatic chronic active hepatitis. Hepatology, (1981) 1:431.}