Geboes et al developed a scale for grading histologic findings seen in colon biopsies from a patient with ulcerative colitis. The changes can be tracked over time. The authors are from KU Leuven in Belgium, McMaster University, Karolinska Institute, Astra Zeneca AB, and Huddiinge University in Sweden.
Parameters:
(1) structural changes (architectural changes) (Grade 0)
(2) chronic inflammatory cell infiltrate (Grade 1)
(3) eosinophilic infiltrate in the lamina propria (Grade 2A)
(4) neutrophilic infiltrate in lamina propria (Grade 2B)
(5) neutrophils in epithelium (Grade 3)
(6) crypt destruction (Grade 4)
(7) erosion, ulceration, granulation tissue (Grade 5)
|
Parameter |
Finding |
Points |
|
structural changes |
normal (no abnormality) |
0 |
|
|
mild abnormality |
1 |
|
|
mild to moderate diffuse |
2 |
|
|
mild to moderate multifocal |
2 |
|
|
severe diffuse |
3 |
|
|
severe multifocal |
3 |
|
chronic inflammatory cells |
no increase |
0 |
|
|
mild increase |
1 |
|
|
moderate increase |
2 |
|
|
marked increase |
3 |
|
eosinophils in lamina propria |
no increase |
0 |
|
|
mild increase |
1 |
|
|
moderate increase |
2 |
|
|
marked increase |
3 |
|
neutrophils in lamina propria |
no increase |
0 |
|
|
mild increase |
1 |
|
|
moderate increase |
2 |
|
|
marked increase |
3 |
|
neutrophils in epithelium |
none |
0 |
|
|
< 5% of crypts involved |
1 |
|
|
5 to 49% of crypts involved |
2 |
|
|
>= 50% of crypts involved |
3 |
|
crypt destruction |
none |
0 |
|
|
probable with local excess of neutrophils in crypt |
1 |
|
|
probable with marked attenuation |
2 |
|
|
definite |
3 |
|
erosion, ulceration, granulation tissue |
none |
0 |
|
|
recovering epithelium plus adjacent inflammation |
1 |
|
|
probable erosion, focally stripped |
2 |
|
|
definite erosion |
3 |
|
|
ulcer or granulation tissue |
4 |
Specialty: Gastroenterology
