Guest guest Posted April 26, 2004 Report Share Posted April 26, 2004 try http://hepatitis-central.com/ A friend of mine runs it. You'll find all the different rating systems for biopsys. Basically, stage 1 is no to very mild fibrosis and stage 4 is cirrhosis. Now there are definitions to each stage and technical words to learn for describing them. There are also other staging systems with more stages, which just means it breaks them down into smaller groups. Look at HISTOLOGY ACTIVITY INDEX (HAI - Knodell Score) http://hepatitis-central.com/hcv/liver/scoring.html On the far left is the FIBROSIS scoring, 0 - 4 0 = no fibrosis 1 = Fibrous portal expansion 3 = Bridging Fibrosis 4 = Cirrhosis (don't ask me what they did with 2) The other columns give you " grades " of the types of fibrosis and cirrhosis found in the liver. So you could have Stage 3, Grade 2 or something (don't quote me, I'm making that part up LOL) but you get the picture. You can have some bridging fibrosis (Grade 3) and some other stuff. Different areas of the liver will be in different stages of breakdown (if they are breaking down). My liver biopsy was a piece of cake. Take a book to read. It was boring. You lay around a lot. My doctor numbed the skin where he was going to do the biopsy then did the biopsy. I didn't feel anything but a sting like a bug bit me. My abdominal muscle twinged and then I was looking at a long sliver of liver! I thot it was cool. Then I had to lay still for an hour and a half or so to make sure I didn't bleed and then I went home. Some people have to lie longer (I was was restless). Let us know how yours goes! Alley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2004 Report Share Posted April 26, 2004 try http://hepatitis-central.com/ A friend of mine runs it. You'll find all the different rating systems for biopsys. Basically, stage 1 is no to very mild fibrosis and stage 4 is cirrhosis. Now there are definitions to each stage and technical words to learn for describing them. There are also other staging systems with more stages, which just means it breaks them down into smaller groups. Look at HISTOLOGY ACTIVITY INDEX (HAI - Knodell Score) http://hepatitis-central.com/hcv/liver/scoring.html On the far left is the FIBROSIS scoring, 0 - 4 0 = no fibrosis 1 = Fibrous portal expansion 3 = Bridging Fibrosis 4 = Cirrhosis (don't ask me what they did with 2) The other columns give you " grades " of the types of fibrosis and cirrhosis found in the liver. So you could have Stage 3, Grade 2 or something (don't quote me, I'm making that part up LOL) but you get the picture. You can have some bridging fibrosis (Grade 3) and some other stuff. Different areas of the liver will be in different stages of breakdown (if they are breaking down). My liver biopsy was a piece of cake. Take a book to read. It was boring. You lay around a lot. My doctor numbed the skin where he was going to do the biopsy then did the biopsy. I didn't feel anything but a sting like a bug bit me. My abdominal muscle twinged and then I was looking at a long sliver of liver! I thot it was cool. Then I had to lay still for an hour and a half or so to make sure I didn't bleed and then I went home. Some people have to lie longer (I was was restless). Let us know how yours goes! Alley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2004 Report Share Posted April 26, 2004 Here is a repost originally from Dr. Misra, and a URL to a nice chart: Knodell's is the basic staging sytem for liver biopsy in asymptomatic chr hepatitis patients and has been subsequently criticised and modified but has stood the test of time well. Ishak and Ludwig are further modifications. How your biopsy is graded There are two primary grading systems for judging the Histology Activity Index (HAI) of your biopsy., The original Knodell's Index ( 1981) has been modified by Ishak (1995), and adapted also by Ludwig ( 1993) In the United States most are given two grades: measurement of scarring or fibrosis is given a " stage, " while inflammation or necrosis in the liver is given a " grade. " Broadly speaking there are four stages of scarring and fibrosis and the indivIdual scores are added to have a HAI. Knodell (1981) I.. Periportal +/-bridging necrosis [score 0-6] II. Intralobular degeneration and focal necrosis (Score 0-4) III. Portal Inflammation (Score 0-4) IV .Fibrosis (Score0-4) Ludwig (1993) I Portal and Lobular Inflammatory Activity Grade 0 -4 II Fibrosis Stage 1-3 Stage 4 Probable or definite cirrhosis Ishak ( 1995) Necroinflammatory Scores A. Periportal (piecemeal necrosis) 0 Absent 1 Mild (focal, few portal areas) 2 Mild/moderate (focal, most portal areas) 3 Moderate around <50% of tracts or septa) 4 Severe (continuous around >50% of tracts or septa) B. Confluent necrosis 0 Absent 1 Focal confluent necrosis 2 Zone 3 necrosis in some areas 3 Zone 3 necrosis in most areas 4 Zone 3 necrosis, plus occasional portal-central (P-C) bridging 5 Zone 3 necrosis, plus multiple P-C bridging Panacinar or multiacinar necrosis C. Focal (spotty) necrosis, and focal inflammation 0 Absent 1 One focus or less per high power field(HPF) 2 Two to four foci per HPF 3 Five to ten foci per HPF 4 More than ten foci HPF D. Portal inflammation 0 None 1 Mild, some or all portal areas 2 Moderate, some or all portal areas 3 Moderate/marked, all portal areas 4 Marked, all portal areas E .Architectural Changes: Fibrosis/Cirrhosis 0 No fibrosis 1 Fibrous expansion of some portal areas 2 Fibrous expansion of most portal areas 3 Fibrous expansion of most portal areas with occasional portal to portal bridging 4 Fibrous expansion of portal areas with marked bridging 5 Marked bridging with occasional nodules (incomplete cirrhosis) 6 Cirrhosis, probable or definite Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2004 Report Share Posted April 27, 2004 alley, same here.. biopsy was easiest time ever dawn Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2004 Report Share Posted April 27, 2004 alley, same here.. biopsy was easiest time ever dawn Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2004 Report Share Posted April 28, 2004 In a message dated 4/26/2004 4:17:16 PM Eastern Daylight Time, alleypat@... writes: Some people have to lie longer (I was was restless). Let us know how yours goes! Both of mine were a walk in the park. Just remember to breath the way your doctor tells you to. That's the most important part. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2004 Report Share Posted April 28, 2004 In a message dated 4/26/2004 4:17:16 PM Eastern Daylight Time, alleypat@... writes: Some people have to lie longer (I was was restless). Let us know how yours goes! Both of mine were a walk in the park. Just remember to breath the way your doctor tells you to. That's the most important part. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2004 Report Share Posted April 28, 2004 I would have let you know how the biopsy went, but it was cancelled due to a health care worker strike. Now I have to wait to be rescheduled. The ironic thing is that it's MY union that's striking! Re: Levels of fibrosis In a message dated 4/26/2004 4:17:16 PM Eastern Daylight Time, alleypat@... writes: Some people have to lie longer (I was was restless). Let us know how yours goes! Both of mine were a walk in the park. Just remember to breath the way your doctor tells you to. That's the most important part. a.. To visit your group on the web, go to: Hepatitis C/ b.. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2004 Report Share Posted April 28, 2004 I would have let you know how the biopsy went, but it was cancelled due to a health care worker strike. Now I have to wait to be rescheduled. The ironic thing is that it's MY union that's striking! Re: Levels of fibrosis In a message dated 4/26/2004 4:17:16 PM Eastern Daylight Time, alleypat@... writes: Some people have to lie longer (I was was restless). Let us know how yours goes! Both of mine were a walk in the park. Just remember to breath the way your doctor tells you to. That's the most important part. a.. To visit your group on the web, go to: Hepatitis C/ b.. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 29, 2004 Report Share Posted April 29, 2004 In a message dated 4/28/2004 1:34:51 PM Eastern Daylight Time, mej42@... writes: I would have let you know how the biopsy went, but it was cancelled due to a health care worker strike. Now I have to wait to be rescheduled. The ironic thing is that it's MY union that's striking! Since when do health care workers go on strike? and why? Maybe we should have all done that a little sooner.............. Anyway, don't be nervous about it. It isn't that painful. Take a book. I went to sleep both times. I was sore on the level of over exercising or a mild stone bruise. Tender to the touch, but handlable. Keep us posted on the rescheduling. Anne Quote Link to comment Share on other sites More sharing options...
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