Table 1 Semiquantitative scoring system using the modified Bonar scale [11]
Subcategory | Grade | |||
|---|---|---|---|---|
0 | 1 | 2 | 3 | |
Tenocytes | Inconspicuous elongated spindle shaped | Increased roundness: Nucleus becomes more ovoid to round in shape | Increased roundness and size: The nucleus is round | Nucleus is round, large |
Ground substance | No stainable ground substance | Stainable mucin between fibers but bundles still discrete | Stainable mucin between fibers with loss of clear demarcation of bundles | Abundant mucin throughout with inconspicuous collagen staining |
Collagen | Collagen arranged in tightly cohesive well demarcated bundles with a smooth dense bright homogeneous polarization pattern with normal crimping | Diminished fiber polarization: Separation of individual fibers with maintenance of demarcated bundle | Bundle changes: Separation of fibers with loss of demarcation of bundles giving rise to expansion of the tissue overall and clear loss of normal polarization pattern | Marked separation of fibers with complete loss of architecture |
Vascularity | Inconspicuous blood vessels coursing between bundles | Occasional cluster of capillaries, less than 1 per 10 high power fields | 1–2 clusters of capillaries per 10 high power fields | Greater than 2 clusters per 10 high power fields |