Synovial Lymphocytic Inflammation

Feature:

Inflammation consisting of any combination of lymphocytes and plasma cells around blood vessels (perivascular aggregates) or in the interstitium

Magnification: 4 – 5x

Grading:

• 0: (none, 23%):  Less than 1 perivascular aggregate in at least 2 fields
• 1: (mild, 29%):  1 perivascular aggregate in at least 2 fields
• 2: (moderate, 28%): >= 2 perivascular aggregates or interstitial inflammation
• 3: (marked, 21%): Widespread perivascular / interstitial aggregates or band-like bridging between blood vessels

Grade 1

Grade 1: A single perivascular aggregate is shown in this image. No other field had more than this; many had less.

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Grade 2

Grade 2: Five identifiable perivascular aggregates with slight interstitial spread are shown in this image. Other fields had no more than this number of aggregates.

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Grade 3

Grade 3: Many perivascular aggregates shown and focally extend into the interstitium connecting the perivascular regions.

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Grade 3 - band

Grade 3 (Band): These widespread perivascular aggregates with dense interstitial inflammation extend between adjacent perivascular regions in a band-like manner.

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