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Ashley Stueck, MD, FRCPC

@liverpath.bsky.social
820 followers 360 following 79 posts

Hepatobiliary pathologist @ Nova Scotia Health and Associate Professor @ Dalhousie University (Halifax, Canada). Head of Autopsy, Digital Pathology. Liver path fellowship director. Views expressed are my own. She/Her. #MedSky #PathSky #LiverSky #GastroSky

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Reposted by Ashley Stueck, MD, FRCPC
Hans Popper Hepatopathology Society @liverpath-hphs.bsky.social · 12/11/2025
📣 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
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Reposted by Ashley Stueck, MD, FRCPC
The Lancet @thelancet.com · 29/07/2025
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
Promotional card for The Lancet Commission on hepatocellular carcinoma. Background image depicts a computer-generated illustration of a human torso with an inflamed liver.
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Reposted by Ashley Stueck, MD, FRCPC
Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 26/06/2025
#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
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Reposted by Ashley Stueck, MD, FRCPC
Arkana Labs @arkanalabs.bsky.social · 12/08/2025
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
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Reposted by Ashley Stueck, MD, FRCPC
ScholarAI Research Agent on Bluesky @scholarai.bsky.social · 16/09/2025
For a detailed review, see "How Molecular Discoveries Have Changed Liver Tumor Pathology: A Brief Review" at meridian.allenpress.com/aplm/articl…
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Reposted by Ashley Stueck, MD, FRCPC
PathologyOutlines.com @pathologyoutlines.bsky.social · 18/09/2025
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
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Reposted by Ashley Stueck, MD, FRCPC
George Finney @georgeefinney.bsky.social · 22/09/2025
🎉 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!
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Reposted by Ashley Stueck, MD, FRCPC
Nature Reviews Gastroenterology & Hepatology @natrevgastrohep.nature.com · 10/10/2025
ICYMI: New online! WNT–β-catenin signalling in hepatocellular carcinoma: from bench to clinical trials
nature.com
WNT–β-catenin signalling in hepatocellular carcinoma: from bench to clinical trials
Nature Reviews Gastroenterology & Hepatology, Published online: 09 October 2025; doi:10.1038/s41575-025-01127-yWNT–β-catenin activation is common in hepatocellular carcinoma (HCC). In this Review, the authors summarize our understanding of the role of WNT–β-catenin activation in HCC — based on results from in vitro and in vivo models — and implications for precision treatment of HCC via targeting β-catenin.
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Reposted by Ashley Stueck, MD, FRCPC
Nature Reviews Gastroenterology & Hepatology @natrevgastrohep.nature.com · 10/10/2025
New online! Bezafibrate for primary biliary cholangitis: time to act on the evidence
nature.com
Bezafibrate for primary biliary cholangitis: time to act on the evidence
Nature Reviews Gastroenterology & Hepatology, Published online: 10 October 2025; doi:10.1038/s41575-025-01135-yAfter the regulatory rejection of obeticholic acid, peroxisome proliferator-activated receptor (PPAR) agonists have emerged as the leading second-line candidates for primary biliary cholangitis, pending definitive approval. Of these, only bezafibrate — a low-cost, widely available generic — has demonstrated long-term efficacy, a fact largely disregarded.
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Reposted by Ashley Stueck, MD, FRCPC
Annalisa Berzigotti @docberza.bsky.social · 10/10/2025
You are unforgettable, and you will always be with us Jaume. www.gastrojournal.org/article/S001...
gastrojournal.org
In Memoriam: Jaume Bosch, MD, PhD
Jaume Bosch, a foundational figure in the study of portal hypertension and one of the giants in hepatology, passed away on July 15, 2025, at age 78 years. He leaves behind an immense body of scientifi...
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Reposted by Ashley Stueck, MD, FRCPC
The Lancet Diabetes & Endocrinology @thelancetendo.bsky.social · 10/10/2025
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
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Reposted by Ashley Stueck, MD, FRCPC
NEJM.org @nejm.org · 27/03/2025
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
Ultrasound and MRI images of the liver
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 26/03/2025
Found IVC abnormalities and tear during procurement explaining the course mimicking hyperacute rejection
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 26/03/2025
🔬Hyperacute rejection expect sinusoidal congestion, hepatic vein congestion, platelet aggregates and fibrin thrombi, erythrophagocytosis, necrosis 🩸This case: z3 congestion, some platelet aggregates 🟢On IF, found C1Q; no C4d ⛔️No DSA
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 26/03/2025
🔷️ A patient with iCCA underwent OLT 1 month after stopping immunotherapy; the liver (ABO compatible) allograft turned blue during perfusion - 😱 Graft removed, plasma exchange and steroids given, 2nd OLT successful
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 26/03/2025
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
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 26/03/2025
Remember to use a PANEL!
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 26/03/2025
🟫Arginase & HSA can be negative in HCC, even grade 1, and occasionally + in other tumours (including hepatoid adenoca); also, beware entrapped non-neoplastic hepatocytes 🟤Glypican-3 helpful in malig vs not, not so much HCC vs not; can stain lipofuscin (pitfall)
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 26/03/2025
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
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 26/03/2025
⚪️ silver (argyria) in liver- Granular pigment in macrophages, can accumulate to extent it causes liver injury and fibrosis; negative on Fe, rhodanine, Schmorl stains 💊 Be aware of homeopathic remedies! #USCAP2025 #pathsky #liversky
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 26/03/2025
@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
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 26/03/2025
👩🏽‍⚕️Communication with hepatologists and history is essential! 🗝Detailed presentation history, past history of liver disease, meds/toxins 🩻 imaging signs of portal hypertension rare in acute fulminant injury #USCAP2025 #pathsky #liversky
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 26/03/2025
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
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 26/03/2025
One of my favourite sessions, the #USCAP2025 liver evening subspecialty conference is about to start! We've got a 🤩💫💯 stacked line-up! #pathsky #liversky
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 26/03/2025
media.tenor.com
a man wearing glasses and an orange suit is standing in a room and says nerd alert .
Alt: Canadian actor Mike Myers, in his role as Austin Powers, says "nerd alert".
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 26/03/2025
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...💅😳
The author's fingernail with two-toned green polish featuring red and gold glitter, matching the USCAP lanyard colours.The author at the USCAP 2024 meeting, captured looking ridiculously enthusiastic, featuring a bright orange wrist cast, a decision she lived with for 6 weeks and may have regretted....
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 26/03/2025
So last #USCAP2025 I had a broken wrist and deliberately matched my cast colour to the theme... This year, I unintentionally matched my nails....
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 24/03/2025
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
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 24/03/2025
@liverpath-hphs.bsky.social 2nd place #USCAP2025 abstract award winner!
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 24/03/2025
RB1 HCC had: - Abrupt anaplasia (82%) - Pseudocysts - Frequent TERT mutations - Poor prognosis 💊Targeted therapies possible
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 24/03/2025
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
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 24/03/2025
@liverpath-hphs.bsky.social 1st place abstract award winner! #USCAP2025
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 24/03/2025
🔴Lack of ERCC1 rs11615 A>G assoc with increased risk of SOS ❗️Can help guide therapy, including dose reductions or escalations! 🧐Maybe this can apply to met CRC NGS from any site!
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 24/03/2025
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
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 24/03/2025
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
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 24/03/2025
🔪Explanted livers in this group not well studied; they studied 9 🩸All had pre-transplant portal htn 🔬NRH, portal vein sclerosis and muscularization, incomplete septal fibrosis, diffuse panzonal CD34 arterialization ⚪️Few with concurrent MASH, had cirrhosis 🤔TBD should be considered in ddx of PSVD
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 24/03/2025
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
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Reposted by Ashley Stueck, MD, FRCPC
Hans Popper Hepatopathology Society @liverpath-hphs.bsky.social · 23/03/2025
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...
hanspopperhepatopathologysociety.org
Membership Application – Hans Popper Hepatopathology Society
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 24/03/2025
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
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Reposted by Ashley Stueck, MD, FRCPC
Elliot Tapper @ebtapper.bsky.social · 23/03/2025
Love this study #liversky journals.lww.com/hepcomm/full... @juanpabloarab.bsky.social
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 24/03/2025
🔪OLTs all for different reasons 👍🏻All able to be managed as out patients ⏳️Both recent and remote OLT patients involved ⚠️COVID-19 could contribute to development of acute cellular rejection, even if COVID symptoms mild #USCAP2025 #liversky #pathsky
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 24/03/2025
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
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 24/03/2025
#USCAP2025 Liver platforms start now in 210C! Excited to learn about some great hepatobiliary research from the next generation of pathologists! #pathsky
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 24/03/2025
There's certainly some overlap in adults as some of these can present late. I've looked for/at Byler bile, Wilson disease, fibrinogen inclusions, canalicular microvilli abnormalities, & microvesicular steatosis in adults over the past few years. But in adult liver I maybe use it 4-5 times a year.
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 24/03/2025
Most common in neonates and pediatrics, where you are mostly looking for aigns of genetic/inheroted diseases, mitochondrial abnormalities, Byler bile in FIC1, microvesicular steatosis, absence of peroxisomes, too much or abnormal glycogen, A1AT globules (can't be seen on light micro until >6 months)
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 23/03/2025
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!
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Ashley Stueck, MD, FRCPC @liverpath.bsky.social · 23/03/2025
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.
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Reposted by Ashley Stueck, MD, FRCPC
Hans Popper Hepatopathology Society @liverpath-hphs.bsky.social · 23/03/2025
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
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