Histopathology of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis

Table 4 Histopathological features of pediatric and adult nonalcoholic fatty liver disease cases n (%)

Item	Score/code	Pediatric (n = 34)	Adult (n = 23)
Steatosis
Grade	0 (< 5%)	0 (0)	0 (0)
	1 (5%-33%)	10 (29)	7 (30)
	2 (> 33%-66%)	15 (45)	14 (61)
	3 (> 66%)	9 (26)	2 (9)
Location	Zone 3	12 (35)	14 (61)
	Zone 1	0 (0)	0 (0)
	Azonal	5 (15)	4 (17)
	Panacinar	17 (50)	5 (22)
Fibrosis
Perisinusoidal1	0 (none)	19 (56)	6 (26)
	1 (mild)	10 (29)	8 (35)
	2 (moderate)	5 (15)	9 (39)
Periportal	0 (none)	18 (53)	13 (57)
	1 (mild)	13 (38)	6 (26)
	2 (moderate)	2 (6)	2 (9)
	3 (severe)	1 (3)	1 (4)
	4 (cirrhosis)	0 (0)	1 (4)
Stage	0 (none)	12 (34)	6 (26)
	1A (mild, zone 3, perisinusoidal)	4 (12)	5 (22)
	1B (moderate, zone 3, perisinusoidal)	2 (6)	2 (9)
	1C (periportal)	7 (21)	0 (0)
	2 (perisinusoidal + periportal)	6 (18)	5 (22)
	3 (bridging fibrosis)	3 (9)	4 (17)
	4 (cirrhosis)	0 (0)	1 (4)
Inflammation
Lobular	0 (no foci)	7 (21)	2 (9)
	1 (< 2 foci per 200 × field)	18 (52)	13 (56)
	2 (2-4 foci per 200 × field)	7 (21)	6 (26)
	3 (> 4 foci per 200 × field)	2 (6)	2 (9)
Portal	0 (none)	11 (32)	10 (43)
	1 (mild)	14 (42)	11 (48)
	2 (moderate)	9 (26)	2 (9)
	3 (severe)	0 (0)	0 (0)
Ballooning	0 (none)	16 (47)	6 (26)
	1 (few)	10 (29)	13 (57)
	2 (many/prominent)	8 (24)	4 (17)
Diagnosis	Not NASH	8 (24)	4 (17)
	Borderline zone 1 NASH	7 (21)	2 (9)
	Borderline zone 3 NASH	5 (15)	5 (22)
	Definite NASH	14 (40)	12 (52)

¹Perisinusoidal fibrosis was significantly milder in pediatric cases than in adult cases. Borderline zone 1 NASH corresponds to type 2 NASH[52]. NASH: Nonalcoholic steatohepatitis.