Pathology of alcoholic liver disease, can it be differentiated from nonalcoholic steatohepatitis?

Table 2 Grading system for alcoholic liver disease[6]

Grade 0-11

Steatosis

0-3 as in NIDDK NASH CRN

Lobular inflammation

0-3 as in NIDDK NASH CRN

Cell death

0 none

1 focal apoptosis

2 many acidophil bodies

3 confluent necrosis

Ballooning

0-2 as in NIDDK NASH CRN

Fibrosis stages 0-6

Stage 1 mild Zone 3 pericellular and/or perivenular

Stage 2 marked Zone 3 fibrosis in most zones 3

Stage 3 fibrous linkage HV to septa

Stage 4 fibrous linkage HV, PT and septa

Stage 5 incomplete or probable cirrhosis

Stage 6 definite cirrhosis

NASH CRN: Nonalcoholic Steatohepatitis Research Network; NIDDK: National Institute of Diabetes and Digestive and Kidney Diseases; HV: Hepatic venule; PT: Portal tracts.