Non-alcoholic fatty liver disease: The diagnosis and management

Table 2 Brunt schema for grading nonalcoholic steatohepatitis[99]

Severe (grade 3)	Moderate (grade 2)	Mild (grade 1)
Typically > 66% (panacinar); commonly mixed steatosis	Any degree and usually mixed macrovesicular and microvesicular	Predominantly macrovesicular; involves < 33%-66% of the lobules	Steatosis
Predominantly zone 3; marked	Obvious and present in zone 3	Occasionally observed; zone 3 hepatocytes	Ballooning
Scattered acute and chronic inflammation; polymorphs may appear concentrated in zone 3 areas of ballooning and perisinusoidal fibrosis	Polymorphs may be noted associated with ballooned hepatocytes, pericellular fibrosis; mild chronic inflammation may be seen	Scattered and mild acute (polymorphs) inflammation and occasional chronic inflammation (mononuclear cells)	Lobular inflammation
Mild or moderate	Mild to moderate	None or mild	Portal inflammation