i received this information from my liver biopsy i need help understanding what it means .
--Final Pathologic Diagnosis---
A. Liver, needle core biopsy:
- Chronic hepatitis with mild activity (grade 2 of 4), portal and
focal periportal fibrosis (stage 2 of 4), consistent with viral Hepatitis
C; see note.
- Minimal macrovesicular steatosis.
Note: The liver needle biopsy has greater than 10 portal tracts
available for evaluation. The hepatic architecture is intact. The portal
areas are expanded by a mild predominantly lymphocytic infiltrate with
admixed histiocytes, occasional neutrophils, eosinophils, and rare plasma
cells. The hepatic artery and portal vein are present and intact. Bile duct
branches are present with no evidence of duct damage. No proliferating bile
ductules are identified at the interface. Mild interface hepatitis is
present in many portal areas with inflammation extending into the lobule.
The lobular parenchyma shows a minimal large and small droplet
macrovesicular steatosis and scattered small clusters of inflammatory
infiltrate. Rare dead hepatocytes are seen. No hepatocytes ballooning or
Mallory-Denk bodies are identified in hepatocytes. Cholestasis is not
present. Central areas and vessels appear unremarkable. A trichrome stain
shows portal and periportal fibrosis with focal pericellular fibrosis and
portal to portal thin bridging. An iron stain does not show iron deposition
within hepatocytes or Kupffer cells.
Basically what it is saying is that you have moderate liver damage, you are grade 2, stage 2.
Grading & Staging a Liver Biopsy
The Metavir scoring system was specially designed for patients with hepatitis C. The scoring consists of using a grading and a staging system. The grade gives an indication of the activity or amount of inflammation and the stage represents the amount of fibrosis or scarring.
The grade is assigned a number based on the degree of inflammation, which is usually scored from 0-4 with 0 being no activity and 3 or 4 considered severe activity. The amount of inflammation is important because it is considered a precursor to fibrosis.
The fibrosis score is also assigned a number from 0-4:
• 0 = no scarring
• 1 = minimal scarring
• 2 = scarring has occurred and extends outside the areas in the liver that contains blood vessels
• 3=bridging fibrosis is spreading and connecting to other areas that contain fibrosis
• 4=cirrhosis or advanced scarring of the liver
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