Original work ACTA.FAC.MED.NAISS. 1998; 15(1), 16-23

CHRONIC HEPATITIS - MODERN TERMINOLOGY AND MORPHOLOGICAL FEATURES
J. Gligorijević, V. Katić, Č. Kutlešić, D. Tasić-Dimov

Investigation of the etiology and pathogenesis of chronic hepatitis results in a clearly stated clinical/morphological attitude regarding the diagnosis and management of these conditions. Hoivever, over time, it has produced a sequence of terminologic indistinctions maling the language used in hepatology quite inconsistent. Problematic were particularly the use of terms chronic active hepatitis (CAH) and chronic persistent hepatitis (CPH), regarding these conditions as diseases per se/separate entities, formulating the treatment procedures for CAH and CPH without etiological determinants.
The need for a standardized/uniform medical terminology urged us to review the history of terminology up to 1994., to demonstrate the classification of chronic hepatitis by an expert group (the same year), and to show the common morphological features of chronic hepatitis types, illustrating the practical application of modern morphological diagnosis and pathological diagnostic reports.
In chronic hepatitis, liver biopsy is performed for several reasons. In some cases, it is essential to get an insight into etiology for a clinically evident disease or to explain the occult laboratory disorders of the liver function. Histological features may confirm the previous clinical diagnosis or give evidence about an alternative or superimposed process. In certain cases, the etiology is known, but the intensity/severity of necroinflammatory activity required for an appropriate therapy or the analysis of this therapy require a morphological analysis. There may be present a disagreement between clinical/laboratory findings and the degree of necrointlammatory changes. In the preclinical stages of cirrhosis, the degree of fibrosis, i.e. stage of the disease is impossible to evaluate clinically. One group of patients has been subjected to biopsy in order to determine the stage of the disease. From practical therapeutic reasons, it is necessary to differentiate between early and late phases of the diasease.
A complete pathological report contains all these details. The form of the report is: diagnosis itself, microscopic description, commentary. It is recomniended that the diagnosis should include: etiology, stage, phase of the disease. Presented is the modified scoring system (HAI) with total score of 18, currently being in use, on a year old material, with the recommendation to use new nomenclature.

Key words: Chronic hepatitis, nomenclature, morphological features, hystory of terminology