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Chronic hepatitis. An update on terminology and reporting
1Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota 55905, USA.
The American Journal of Surgical Pathology
|December 1, 1995
Summary
The terms chronic active hepatitis (CAH), chronic persistent hepatitis (CpH), and chronic lobular hepatitis (CLH) are obsolete. Pathologists should use clear etiologic terminology, including grade and stage, for accurate hepatitis diagnosis and treatment.
Area of Science:
- Hepatology
- Pathology
- Medical Terminology
Background:
- The terms chronic active hepatitis (CAH), chronic persistent hepatitis (CpH), and chronic lobular hepatitis (CLH) have been used historically for liver biopsy interpretation.
- These terms have evolved from descriptive grading to ambiguous diagnostic labels, causing significant misunderstandings in clinical practice.
Observation:
- The current use of CAH, CpH, and CLH lacks specificity, leading to potential misinterpretations of liver disease etiology and severity.
- Individual preferences in applying these terms have resulted in inconsistent diagnostic reporting.
Findings:
- A clear, etiologic-based terminology for chronic hepatitis is recommended by experts to replace obsolete terms.
- Pathologists should report liver biopsy findings by specifying etiology, grade, and stage (e.g., autoimmune hepatitis, severe, stage 3).
- Integrating morphologic findings with clinical and laboratory data is crucial for accurate etiologic diagnosis.
Implications:
- Adopting standardized etiologic terminology will eliminate ambiguity in hepatitis diagnosis, reducing the risk of inappropriate treatment.
- This revised reporting practice ensures clearer communication between pathologists and clinicians, improving patient care.
- For a transitional period, obsolete terms can be included in parentheses to aid in relearning and adoption of the new system.