肝移植における急性細胞性拒絶acute cellular rejection ACRのscoring system
2007年8月30日
※下記の日本語訳は筆者による
| カテゴリー | クライテリア | スコア |
| 門脈の炎症(P) Portal Inflammation | 少数のグリソン鞘にほとんどがリンパ球からなる浸潤を認めるが、グリソン鞘の拡大は目立たない Mostly lymphocytic inflammation involving, but not noticeably expanding, a minority of the triads | 1 |
| 時に芽球を伴うリンパ球、好中球、好酸球を含む混合性炎症細胞浸潤によるほとんど全てのグリソン鞘の拡大 Expansion of most or all of the triads, by a mixed infiltrate containing lymphocytes with occasional blasts, neutrophils and eosinophils | 2 | |
| 多数の芽球、好酸球を含む混合性炎症細胞浸潤によるほとんど全てのグリソン鞘の著しい拡大と、炎症の門脈域周囲肝実質への逸出 Marked expansion of most or all of the triads by a mixed infiltrate containing numerous blasts and eosinophils with inflammatory spillover into the periportal parenchyma | 3 | |
| 胆管の炎症/傷害(B) Bile Duct Inflammation Damage | 少数の胆管が炎症細胞による傷害・浸潤をうけ、軽度の反応性変化（上皮細胞のN/C比上昇など）を示す A minority of the ducts are cuffed and infiltrated by inflammatory cells and show only mild reactive changes such as increased nuclear:cytoplasmic ratio of the epithelial cells | 1 |
| ほとんどの胆管に炎症細胞浸潤。一つ以上の一部胆管に核の大小不同、空胞化などの変性 Most or all of the ducts infiltrated by inflammatory cells. More than an occasional duct shows degenerative changes such as nuclear pleomorphism, disordered polarity and cytoplasmic vacuolization of the epithelium | 2 | |
| ほとんどの胆管に変性、一部に内腔の途絶。 As above for 2, with most or all of the ducts showing degenerative changes or focal lumenal disruption | 3 | |
| 静脈内皮炎(V) Venous Endothelial Inflammation | 大部分ではないが、一部の門脈and/or中心静脈に血管内皮下のリンパ球浸潤 Subendothelial lymphocytic infiltration involving some, but not a majority of the portal and/or hepatic venules | 1 |
| ほとんど、ないし全ての門脈and/or中心静脈に血管内皮下のリンパ球浸潤 Subendothelial infiltration involving most or all of the portal and/or hepatic venules | 2 | |
| 中心静脈周囲の実質に拡大する中等度から高度の血管周囲炎と血管周囲肝細胞壊死 As above for 2, with moderate or severe perivenular inflammation that extends into the perivenular parenchyma and is associated with perivenular hepatocyte necrosis | 3 |
Total RAI Score = _/9
執筆日：2007/8/30
執筆者：神戸大学病院病理部病理診断科 伊藤 智雄
