Table 3.
Histological scoring system for ulcerative colitis and Crohn’s disease
| Ulcerative colitis | |
| Grade 0 | Structural (architectural change) |
| 0 | No abnormality |
| 0.1 | Mild abnormality |
| 0.2 | Mild or moderate diffuse or multifocal abnormalities |
| 0.3 | Severe diffuse or multifocal abnormalities |
| Grade 1 | Chronic inflammatory infiltrate |
| 1 | No increase |
| 1.1 | Mild but unequivocal increase |
| 1.2 | Moderate increase |
| 1.3 | Marked increase |
| Grade 2 | Lamina propria neutrophils and eosinophils |
| 2A. Eosinophils | |
| 2A.0 | No increase |
| 2A.1 | Mild but unequivocal increase |
| 2A.2 | Moderate increase |
| 2A.3 | Marked increase |
| 2B. Neutrophils | |
| 2B.0 | None |
| 2B.1 | Mild but unequivocal increase |
| 2B.2 | Moderate increase |
| 2B.3 | Marked increase |
| Grade 3 | Neutrophils in epithelium |
| 3 | None |
| 3.1 | < 5% crypt involved |
| 3.2 | < 50% crypt involved |
| 3.3 | > 50% crypt involved |
| Grade 4 | Crypt destruction |
| 4 | None |
| 4.1 | Probable-local excess of neutrophils in part of crypt |
| 4.2 | Probable-marked attenuation |
| 4.3 | Unequivocal crypt destruction |
| Grade 5 | Erosion or ulceration |
| 5 | No erosion, ulceration, or granulation tissue |
| 5.1 | Recovering epithelium plus adjacent inflammation |
| 5.2 | Probable erosion-focally stripped |
| 5.3 | Unequivocal erosion |
| 5.4 | Ulcer or granulation tissue |
| Crohn’s disease | |
| Epithelial damage | |
| 0 | Normal |
| 1 | Focal pathology |
| 2 | Extensive pathology |
| Architectural changes | |
| 0 | Normal |
| 1 | Moderately disturbed (< 50%) |
| 2 | Severely disturbed (> 50%) |
| Infiltration of mononuclear cells in the lamina propria | |
| 0 | Normal |
| 1 | Moderate increase |
| 2 | Severe increase |
| Infiltration of polymorphonuclear cells in the lamina propria | |
| 0 | Normal |
| 1 | Moderate increase |
| 2 | Severe increase |
| Polymorphonuclear cells in the epithelium | |
| 1 | In surface epithelium |
| 2 | Cryptitis |
| 3 | Crypt abscess |
| Presence of erosions and/or ulcers | |
| 0 | No |
| 1 | Yes |
| Presence of granuloma | |
| 0 | No |
| 1 | Yes |
| No. of biopsy specimens affected | |
| 0 | None (0 of 6) |
| 1 | < 33% (1 or 2 of 6) |
| 2 | 33%-66% (3 or 4 of 6) |
| 3 | > 66% (5 or 6 of 6) |
Each topic scored independently. Moderate increase, up to twice the number of cells that can normally be expected; severe increase, more than twice the normal number of cells.