Confused on BX pathology results ??

[Lady Lauri]

  While my Dr. has said I was stage 3 (on the 1-6 scale) fibrosis...... I got a copy of the patholgy report. He wasn't at my blood draws last Friday (saw him days before) to ask about this. It reads....

Core segmants of pink-tan to red soft tissue, range from 0.2-1.1 cm in length and 0.1 in diameter.

Chronic hepatitis, HAI grade (2 + 0 +2 +2 ) = 6

Fibrosis stage 3/6

No steatosis

Masson trichrome, PAS and PAS-D support the above diagnosis

Had thought the fibro scan showed lower damage, guess it matched pretty well? ( line 5?)
Believe the stage is 3 OF 6, right ? (line 3.)

Please explain in laymans terms about the  HAI 'grade'... is that the scale they used or the 'grade'? Confused here, only been told stage 2/3 fibrosis, no grade? What exactly is it when you say
'stage 3, GRADE 2'....as in whats 'grade'? Sorry, just can't get that straight in my head!!

                                                                    Thanks, LL

[jmjm530]

LOL. This may be the reason the Metavir system is used more often.

To try and simplify...

it appears that you would be between stage 2-3 if the Metavir scoring system was used. That would be the important number. This then indicates
"...occasional portal to portal (P-P) bridging" (see previous post) but not the complete bridging seen with stage 3. As far as inflammation/grade is concerned, your inflammaion is "mild". (again see above posts).

Of course, confirm with your doctor, or the BMW dealer -- whichever is smarter.

-- Jim

[Lady Lauri]

  Just saw that 2nd post. Haven't googled yet, about to. Problem googling right now is this hazy brain syndrome...everything takes twice, 3 times the time!! As I am sure you know. And doesn't take much to 'confuse me more' right now, LOL.
I could also wait and get Dr. Nelson to explain it better! I've never been quoted a 'grade', just quoted
'2/3 fibrosis, and he didn't want me to wait for tx, started right away. I figure he's more worried about how one progress's fast and one may not, etc.
  And your right, reading 'thier' terms is making me feel really ...stupid! Understanding all the mumbo jumbo. I have come a LONG way on here tho!

Have to say, this is the first time since coming on med help (@8mths now?) that I have seen jmjm 'stumped' !! Guess he better go back to grade school...LMAO. Or maybe it's cause he was studying the wrong things in grade school :} ?

                                                                                         LL

                                                                                     LL

[Lady Lauri]

......."I'll show you my BMW if you show me yours". Definitely more success using that approach.....

And again, LMAO. Great line :}  I'm sure that worked well, but what if she also had a BMW??
  Uhhhh....and I meant the dermatologist credentials!!!

Gauf........did your parents have a BMW in grade school?? :} I mean, to get you to Busch Gardens and so early :}  ?

                                                                                     LL

[wyntre9]

They DON"T make it easy for us non-medical people to figure the stuff out.  (IMHO).  It's like having a dozen different, all acceptable, spellings of the same word and being told each is correct.

Did you try googling on the HAI system as whrose suggested?  i'd try to help out but I'm sure I'd confuse you even more.  *LOL*

wyn

[Lady Lauri]

That's what I am hoping :} Just never 'got' what the 'grade' part means in this...it's a duh thing!

                                                                                       LL

[wyntre9]

There are several scoring systems for damage levels and it can get very confusing.

My fibrosure said stage 4, fibrosis, while the biopsy said stage 1 grade 1.

I don't know what HAI is but if it's mild inflamation, like Whrose says, that's a good sign.

wyntre

[gauf]

While you were studying in grade school, I was lounging in Busch Gardens.

[jmjm530]

LL: BTW....your credentials please ??
------------------------------------------------------
I've both studied and been in awe of the female chest from earliest memories.

Like most men, I began my studies in grade school although it took awhile before my technique developed to the point where I had much success. Lines like "I'll show you mine if you show me yours", only got me so far.

Later in life, as an adult, I realized that a better line was "I'll show you my BMW if you show me yours". Definitely more success using that approach.

My best years were probably in the 70's when bra's were being being burned as well as everything else, as I never could operate all those hooks and clips just right.

Lately, I'm a little rusty, but hopefully my past CV is enough.


-- Jim

[Lady Lauri]

...........BTW I still need more time on that Chest diagnosis, but if the weather's cold where you live, a light (but tight) sweater is OK to wear :) ..........................

LMAO!    H*LL..... it's cold in Fla. right now, put the sweater on yesterday!! Gave up on you!

( How do you work this *&%$#@##$%% web cam !!!!????    :}

BTW....your credentials please ??

                                                                                            LL

[Lady Lauri]

  jmjm.....now I am more confused! The metavilr system being the 1-4 scale?
Will check out your links, Janis site when I am back later. Will post how he explains it when I see him also.

whrose....thank you for doing that! Will check out hcv site also. He'd said 'stage 2-3' a few times and has even said , SVR providing......my liver can still repair itself some, all.

                                                                                  Thanks much,

                                                                                                  LL

[Whrose]

the first number  3= amount of necrosis (this goes up to 10)
the second number 6= amount of inflammation

HAI= histology activity index

your score of 6 =mild inflammation

i got it from http://hcvadvocate.org/hepatitisfactsheets_pdf/grade_stage.pdf

hope this helps     good luck

[jmjm530]

I'll also go out on a limb and speculate that you can read across the first chart in the second study posted and plug in (2,0,2,2) respectively for a total inflammatory score of "6" which according to Table 6 in the first link (The Janis link) would translate into "Mild" Activity. Again, just flying by wire here and all this should be confirmed.

[jmjm530]

This might be a more helpful chart:
http://tpis.upmc.edu/tpis/schema/mHAI.html

If I'm reading it correctly, your stage 3 Fibrosis would be (according to second chart)

"Fibrous expansion of most portal areas with occasional portal to portal (P-P) bridging"

That would probably be the equivilent of a stage 2-3 on the more used Metavir scale where stage 3 is bridging fibrosis with more complete bridging. But again, not as familiar with this scale as Metavir, so do go over all this with your doc.

-- Jim

[jmjm530]

Of course, you couldn't stick with the ole' Metavlir system and had to go complicated on us. You might want to read this description over at the Janis site, although I confess I was a bit confused at first glance, but then no coffee yet today. Probably best to have a nice chat with your doctor. Surprised the report didn't have more verbage on the extent of Fibrosis. BTW I still need more time on that Chest diagnosis, but if the weather's cold where you live, a light (but tight) sweater is OK to wear :)

http://www.janis7hepc.com/biopsies.htm#scoring%20and%20grading%20biopies