📣 Upcoming Webinar Nov 14! 🔬Immunity and the Liver: A trio of interesting cases 🧐 ⭐️ Drs Emily Wilson & Jingmei Lin (Wake Forest), Joshua Wong & Sadhna Dhingra (Houston Methodist), and Julia Gallardo & James Mitchell (UT Southwestern) 📨 Check your email for registration info! #pathsky #liversky

The global burden of liver cancer is increasing. 📈 Hepatocellular carcinoma (HCC) accounts for approximately 80% of cases globally. 💡 A new Commission outlines evidence-based recommendations for action to reduce the global HCC burden: tinyurl.com/yzxvktkw

#idboardreview 60 F returned from Bolivia, consumed a lot of watercress presents w/ RUQ pain, wt loss, icterus, wbc15k 60%eos, BC neg, LFTs 5x upper limit of normal, normal Alk P, Hepatitis A,B,C negative, CXR neg. StoolO&P negative. dx? #idmedEd #meded #IDsky #idfellows #idfellowship

1/ Bile cast nephropathy is one cause of acute or chronic kidney injury in patients with liver disease (especially obstructive cholestasis). Figure 1 shows two paraffin blocks containing kidney biopsies from two different patients. #TeachingPoints #kidneypath #renal #pathology

For a detailed review, see "How Molecular Discoveries Have Changed Liver Tumor Pathology: A Brief Review" at https://meridian.allenpress.com/aplm/article/148/5/e96/495433

Case of the Month: A 67 year old man with a history of chronic obstructive pulmonary disease, prediabetes and abdominal imaging consistent with cirrhosis underwent a non-targeted liver biopsy. What's your diagnosis? See link in comments for the case! #Pathology #PathologyOutlines #Diagnosis

🎉 Hot off the press! Our new review on liver resident CD8+ T cells is here - exploring the dual nature of these cells either as protective "Jekyll" 😇 or pathogenic "Hyde” 😈 Dive in to see how the liver microenvironment shapes TRM immunity, pathology & therapeutic potential!

ICYMI: New online! WNT–β-catenin signalling in hepatocellular carcinoma: from bench to clinical trials

New online! Bezafibrate for primary biliary cholangitis: time to act on the evidence

You are unforgettable, and you will always be with us Jaume. www.gastrojournal.org/article/S001...

There is substantial heterogeneity in the contributors to the pathophysiology of #MASLD, which might influence its rate of progression, its relationship with #cardiometabolic diseases, and the response to therapy www.thelancet.com/journals/lan... #OpenAccess #MedSky #EndoSky #LiverSky #HepSky

Case Record of the MGH: A 59-year-old man with a history of metabolic dysfunction–associated steatotic liver disease had an enlarging liver mass. Biopsy showed hepatocellular carcinoma. Management decisions were made. Read the full case details: nej.md/41Vvxbv #MedSky #GastroSky

Dr Sadnha Dhingra 💊 Immunotherapy may be used as a bridge to transplant for iCCA 🌊Plan for 3 month washout period or increased risk of rejection (T cell- & antibody-mediated) #USCAP2025 #pathsky #liversky

Dr Vishal Chandan 😲5-10% of HCC can express CDX2 ❗️SATB2 can also be seen in HCC: 40-60%! HCCs with the above usually poorly diff, poor prognosis 🟤5-10% of HCC are K20+ 📖Remember that "biliary" keratins, K7 & K19, can also be seen in HCC; the latter can be prognostic #USCAP2025 #pathsky #liversky

@alboothmd.bsky.social 🎨 Pigments which can be seen in the liver: iron, copper, gold, melanin, and silver! 🍴 Silver supplements exist, so do instructions on how to DIY (no medical indication exists); can also be exposed via occupation, topical, or inhalation exposure #USCAP2025 #pathsky #liversky

Dr Mary Bronner 😱Fulminant necrosis with collapse can mimic cirrhosis 🔬Quality trichrome impt!Necrosis supported by granular necrotic appearance on HE, Kupffer cells (HE, PAS/D), two-toned trichrome (one-toned in F4), reticulin may be hard to interpret #USCAP2025 #pathsky #liversky

One of my favourite sessions, the #USCAP2025 liver evening subspecialty conference is about to start! We've got a 🤩💫💯 stacked line-up! #pathsky #liversky

So last #USCAP2025 I had a broken wrist and intentionally matched my cast colour to the theme colours... This year I unintentionally (!) did it with my manicure...💅😳

So last #USCAP2025 I had a broken wrist and deliberately matched my cast colour to the theme... This year, I unintentionally matched my nails....

Dr Ruoyu Shi 🎯Residual viable HCC volume % by pathology is still best way to quantify treatment response 🗣Propose 0% = complete pathologic response, <10% residual tumour = major pathologic response; significantly correlates with OS, RFS #USCAP2025 #pathsky #liversky

@liverpath-hphs.bsky.social 2nd place #USCAP2025 abstract award winner!

Dr Yulin Haw ⚪️Chromophobe HCC has abrupt anaplasia, pseudocysts, ALT phenotype, no TERT mutations, and no progress significance 🧐RB1 mutations found in some HCC with abrupt anaplasia, prompting study 📊7.5% of >600 HCC had RB1 muts! #USCAP2025 #liversky #pathsky

@liverpath-hphs.bsky.social 1st place abstract award winner! #USCAP2025

Dr Mengxue Zhang 🧬 gene polymorphisms alter risk of oxaliplatin-induced SOS; usually detected on blood 📓Reanalyzed liver met CRC NGS in 79 cases (12 with SOS) for SOS assoc polymorphisms 🔴ERCC1 rs11615 A>G can be found, was sig assoc with protection vs SOS #USCAP2025 #liversky #pathsky

Dr Melissa Duarte 🟢 36 PBC patients, 17 treatment naive and 18 treated (not paired) 💊In treated, less florid duct lesions and chronic cholangitis activity (per Nakanuma), more duct loss, higher stage ⛔️No differences in K7, copper, loss of canals of Hering #USCAP2025 #liversky #pathsky

Dr Ashwin Akki 🧬 Telomere biology disorders (TBD) can present in adulthood, often more cryptic than in kids and more single-organ disease 😮Advanced liver disease in 1/3 🔬Portal vein abnormalities, NRH, fibrosis (PSVD spectrum) described in biopsies #USCAP2025 #liversky #pathsky

Welcome to our new members inducted at our business meeting today at #USCAP2025! Want to become a member (fyi, no dues pathologists-in-training)? #liversky #pathsky hanspopperhepatopathologysociety.org/membership-a...

Dr Byoung UK Park 🤖Developed a supervised AI model for MASH grading/staging on trichromes 👩🏻‍🏫Trained on 161 WSI from different labs & scanners, 36 were annotated by 4 pathologists 🖨Output as heat maps and quantitative 👾strong agreement with pathologists except for inflam #USCAP2025 #liversky #pathsky

Love this study #liversky journals.lww.com/hepcomm/full... @juanpabloarab.bsky.social

Dr Jasmine Wang - 😷 found 7 patients who developed acute cellular rejection after COVID-19 💊All med compliant 🤒Most mild-mod infection, no admissions 🤢All had GI symptoms, elevated liver enzymes 🔬Mild-severe rejection; 1 plasma cell rich, 2 with cholestatic injury #USCAP2025 #liversky #pathsky

#USCAP2025 Liver platforms start now in 210C! Excited to learn about some great hepatobiliary research from the next generation of pathologists! #pathsky

Me whenever I have to do EM: 😬, clutching the Philips textbook I inherited from Dr Wanless Me whenever the EM has to be on glut post-fixed FFPE (which is most of the time): 😬😭 Needless to say, I'm excited 😃 that the Society for Ultrastructural Pathology #USCAP2025 companion meeting has a liver case!

Whew! Whirlwind of a day, lots of great learning and socializing. Thanks to @liverpath-hphs.bsky.social for letting me takeover their BlueSky during their #USCAP2025 Companion meeting! Looking forward to the reception tonight.

Good morning liver-lovers! Our Companion #USCAP2025 meeting starts NOW! @liverpath.bsky.social will be taking over our feed to live skeet the event! #liversky #pathsky

Dr Alkhouri 🤔MetALD vs MASLD vs ASD? 🍸all depends on the dose of alcohol 🍷MetALD can lead to increased fibrosis and disease activity vs MASH alone 😷Met ALD is an increasing cause of liver transplant #liversky #pathsky #USCAP2025

Dr Alkhouri 🥼trials coming for MetALD 📊MAESTRO-NASH data used, re-evaluated as some MetALD (10%) vs pure MASH (90%) 📉MetALD younger, less DM, worse biochem, but showed similar steatohepatitis resolution & fibrosis improvement #USCAP2025 #liversky #pathsky

In the Q&A, Dr Schirmacher brings up some great discussion around continued uncertainty/unknowns in new categorization, retrospectively categorizing pathology, categorization not 🙅‍♂️ equal to what is happening in disease, lack of clinical info available to pathologists #USCAP2025 #liversky #pathsky

In the Q&A, PNPLA3 stratification may be coming in trials! Pathologists can help raise concern for #USCAP2025 #liversky #pathsky

Dr Allende_ 👏🏻Gives us some history and highlights the amazing 20 year work done by the NASH CRN! 🔬Reproducility good within NASH CRN group #USCAP2025 #liversky #pathsky

Dr Allende Helpful paper on various appearances of ballooning: journals.lww.com/hepcomm/full... #USCAP2025 #liversky #pathsky

Dr Allende 🪜Stage 1c - a big portal tracts not enough, pericellular periportal helpful ⚪️Microvesicular steatosis doesn't count toward total steatotic % 🔬Lipogranulomas not counted toward inflammatory foci #USCAP2025 #liversky #pathsky

Dr Allende 🟣Glycogenosis common, be careful not to mistake for ballooning 🧬More glycogenosis may be associated with certain genetic mutations, could be protective vs HCC and more #USCAP2025 #liversky #pathsky

Dr Allende 🔬Our diagnoses are still steatosis, steatohepatitis 🍸EtOH more likely if well-formed Mallory-Denk, neutrophils 🧐How much portal inflam is too much? Most have (also usually mild interface activity)! May be a marker of aggression. #USCAP2025 #liversky ##pathsky

Dr Allende Staging difficulties: Poor trichrome stains Trichrome staining other things (retic, histiocytes) blue Thin and fragmented biopsies #USCAP2025 #liversky ##pathsky

Dr Allende Regression can be seen post-treatment Regression vs progression still being studied; ex. Type 2 pediatric pattern can mimic regression! pubmed.ncbi.nlm.nih.gov/11079009/ #USCAP2025 #Liversky ##pathsky

Dr Allende Where are we going? 💉Biopsies still important! 🤖AI and other technologies coming, but have some limitations vs pathologists #USCAP2025 #liversky #pathsky

Good recap. Involving pathologists ensures AI isn't misled by fragmented EUS biopsies—someone's got to anchor those models in clinical reality. Standardizing methods is the only way to filter signal from noise.

In the Q&A, excellent points: 💉More EUS biopsies being done, often thin, fragmented - should we recommend or standardize methods? 🤖Pathologists must be involved in AI development, training, testing! #USCAP2025 #liversky #pathsky