Table 1.
Brunt classification of steatohepatitis[27]
Grades of NASH | |
Grade 1 (mild) | Steatosis up to 66%. Occasional ballooned hepatocytes predominantly in zone 3. Scattered intra-acinar neutrophils |
Grade 2 (moderate) | Steatosis of any degree. Ballooned hepatocytes predominantly in zone 3. Intra-acinar neutrophils. Zone 3 perisinusoidal fibrosis. Mild to moderate portal and intra-acinar chronic inflammation |
Grade 3 (severe) | Panacinar steatosis. Widespread ballooned hepatocytes predominantly in zone 3. Intra-acinar inflammation. Scattered neutrophils associated with ballooned hepatocytes. Mild to moderate portal inflammation |
Stages of NASH | |
Stage 1 | Extensive zone 3 perisinusoidal fibrosis |
Stage 2 | Zone 3 perisinusoidal and portal or periportal fibrosis |
Stage 3 | Bridging fibrosis |
Stage 4 | Cirrhosis |
NASH: Non-alcoholic steatohepatitis.