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Hep C Discussion Forum -> General Discussion -> Deciphering liver biopsy report
Post Info TOPIC: Deciphering liver biopsy report
mallani


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RE: Deciphering liver biopsy report
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Hi Mopey,

I have mostly used the Metavir system for scoring a liver biopsy. There are several other systems, and Ishak is also good.

The main objection to the Ishak grading system is the complexity. Using your report, this equates to Metavir A3, which is moderate inflammation.

There is also some confusion about the Ishak staging system for fibrosis. With a range of 0-6, a fibrosis stage of 5-6/6 means differing interpretations.

Have another read of your report. Does it mention whether 'regenerating nodules' are present? Every Pathologist I know uses this as the hallmark of cirrhosis (Metavir F4).

If regenerating nodules are present, you are A3, F4 on Metavir. If not, you are A3, F3-4.

Forget the NAFLD score. It is not widely accepted. You have a borderline fatty liver. Hope this helps.



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Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
Tig


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Here is an interesting (?) comparison between the Ishak and Metavir scoring system.

http://cdn.intechopen.com/pdfs-wm/18773.pdf

Tig



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Tig

68yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 9+ years!

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Audreyanna


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Ive always wondered why neither of my biopsies were "graded". They were just in narrative form. All I know is the first showed bridging fibrosis and second showed cirrhosis. I was just told to use an online calculator to calculate my MELD score.

But yes, Mallani will know. We are so lucky to have him on this forum! Good luck!



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Audrey

 

55 y/o, GT 1A, 1.4 million UI, cirrhosis, low platelets, enlarged spleen, high LFTs. Failed tx x2. 12 weeks Sovaldi/Olysio. Undetected end of treatment and 4 weeks after EOT!
Huey


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Mopey wrote:

Hi everyone,

I initially posted this question as part of a different post but I thought it would be better to ask it on its own. I was looking over the results from my liver biopsy, and I wonder if some of you may help me decipher it. Here are the scores I was given:

 

ISHAK score:

Fibrosis stage 5-6/6

Grade 6/18 (portal inflammation 3/4, lobulitis 2/4, interface change 1/4, confluent necrosis 0/6)

 

NAFLD Activity score: 4/8 (Borderline for steatohepatitis)

Steatosis: 2/3

Lobulitis: 2/3

Ballooning: 0/2

 

There is more written on the report but I wasn't sure how much to include. I was described as having severe fibrosis, but this seems closer to cirrhosis? I know most people on this forum employ Fibroscan scores, but I wasn't sure how to translate between the ISHAK scale and Fibroscan scale. How would this be translated into the Fibroscan scoring system, would I be an F4 or is there any chance I might be an F3?  Any insight would be greatly appreciated.

 Mallani is the expert on this,, This is what he does.  He will be on later and see this, His answer is the best.



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  HCV Genotype 3a , now Psot-Tx was on S/riba. First VL was 5.8 mil on 7-5-13 then "und" at 3.8 weeks. 06/13/14 still und. off meds 3 days back on 7/29 Last pill 08/10/14 SVR+4

 
Mopey


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Hi everyone,

I initially posted this question as part of a different post but I thought it would be better to ask it on its own. I was looking over the results from my liver biopsy, and I wonder if some of you may help me decipher it. Here are the scores I was given:

 

ISHAK score:

Fibrosis stage 5-6/6

Grade 6/18 (portal inflammation 3/4, lobulitis 2/4, interface change 1/4, confluent necrosis 0/6)

 

NAFLD Activity score: 4/8 (Borderline for steatohepatitis)

Steatosis: 2/3

Lobulitis: 2/3

Ballooning: 0/2

 

There is more written on the report but I wasn't sure how much to include. I was described as having severe fibrosis, but this seems closer to cirrhosis? I know most people on this forum employ Fibroscan scores, but I wasn't sure how to translate between the ISHAK scale and Fibroscan scale. How would this be translated into the Fibroscan scoring system, would I be an F4 or is there any chance I might be an F3?  Any insight would be greatly appreciated.



__________________

42 year old male

Genotype 3; co-infected with Hep B.

Ended 24 week course of Interferon + Ribavirin on November 17, 2014. UND at end of treatment, relapsed 3 months post-TX.  

ISHAK Score: Fibrosis 5-6/6    Grade 6/18

 

 

 
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