Non-alcoholic fatty liver disease: An expanded review

Table 3 Brunt grading and staging of nonalcoholic steatohepatitis[96]

Grading	Staging
Mild (Grade 1)	Stage 1
Steatosis (mostly macrovesicular)	Zone 3 perisinusoidal/pericellular fibrosis (focal or extensive)
Involves up to 66% of biopsy
Occasional ballooned zone 3 hepatocytes	Stage 2
Scattered rare intra-acinar neutrophils with/without associated lymphocytes	Zone 3 perisinusoidal/pericellular fibrosis with associated focal or extensive periportal fibrosis
No/mild portal chronic inflammation
Moderate (Grade 2)
Steatosis-any degree
Ballooning hepatocytes-zone 3
Intra-acinar neutrophils-may be associated with zone 3 pericellular fibrosis	Stage 3
Portal and intra-acinar chronic inflammation	Zone 3 perisinusoidal/pericellular fibrosis and portal fibrosis with associated focal or extensive bridging fibrosis
Severe (Grade 3)
Panacinar steatosis
Ballooning-zone 3
Intra-acinar inflammation with scattered neutrophils	Stage 4
Neutrophils associated with ballooned hepatocytes with/without chronic inflammation	Cirrhosis
Chronic portal inflammation-mild or moderate