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Article ; Online: Langerhans cell histiocytosis of the thyroid mimicking thyroiditis in a boy: a case report and literature review.

Cheng, Yu Fan / Wang, Ching Che / Tsai, Pei Shan / Lin, Dao Chen / Huang, Wen Hui

2024 Volume 24, Issue 1, Page(s) 66

Abstract: Background: Langerhans cell histiocytosis affecting the thyroid commonly presents with nonspecific clinical and radiological manifestations. Thyroid Langerhans cell histiocytosis is typically characterized by non-enhancing hypodense lesions with an ... ...

Abstract	Background: Langerhans cell histiocytosis affecting the thyroid commonly presents with nonspecific clinical and radiological manifestations. Thyroid Langerhans cell histiocytosis is typically characterized by non-enhancing hypodense lesions with an enlarged thyroid on computed tomography medical images. Thyroid involvement in LCH is uncommon and typically encountered in adults, as is salivary gland involvement. Therefore, we present a unique pediatric case featuring simultaneous salivary and thyroid involvement in LCH. Case presentation: A 3-year-old boy with complaints of an anterior neck mass persisting for 1 to 2 months, accompanied by mild pain, dysphagia, and hoarseness. A physical examination revealed a 2.5 cm firm and tender mass in the left anterior neck. Laboratory examinations revealed normal thyroid function test levels. Ultrasonography revealed multiple heterogeneous hypoechoic nodules with unclear and irregular margins in both lobes of the thyroid. Contrast-enhanced neck computed tomography revealed an enlarged thyroid gland and bilateral submandibular glands with non-enhancing hypointense nodular lesions, and multiple confluent thin-walled small (< 1.5 cm) cysts scattered bilaterally in the lungs. Subsequently, a left thyroid excisional biopsy was performed, leading to a histopathological diagnosis of LCH. Immunohistochemical analysis of the specimen demonstrated diffuse positivity for S-100, CD1a, and Langerin and focal positivity for CD68. The patient received standard therapy with vinblastine and steroid, and showed disease regression during regular follow-up of neck ultrasonography. Conclusions: Involvement of the thyroid and submandibular gland as initial diagnosis of Langerhans cell histiocytosis is extremely rare. It is important to investigate the involvement of affected systems. A comprehensive survey and biopsy are required to establish a definitive diagnosis.
MeSH term(s)	Child, Preschool ; Humans ; Male ; Biopsy ; Histiocytosis, Langerhans-Cell/diagnostic imaging ; Histiocytosis, Langerhans-Cell/complications ; Neck/pathology ; Thyroiditis/complications
Language	English
Publishing date	2024-01-20
Publishing country	England
Document type	Review ; Case Reports ; Journal Article
ZDB-ID	2041342-7
ISSN	1471-2431 ; 1471-2431
ISSN (online)	1471-2431
ISSN	1471-2431
DOI	10.1186/s12887-023-04494-0
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Article: Usefulness of Diffusion-Weighted Imaging in Evaluating Acute Cellular Rejection and Monitoring Treatment Response in Liver Transplant Recipients.

Chiang, Hsien-Jen / Chuang, Yi-Hsuan / Li, Chun-Wei / Lin, Chih-Che / Eng, Hock-Liew / Chen, Chao-Long / Cheng, Yu-Fan / Chou, Ming-Chung

Diagnostics (Basel, Switzerland)

2024 Volume 14, Issue 8

Abstract: Acute cellular rejection (ACR) is a significant immune issue among recipients following liver transplantation. Although diffusion-weighted magnetic resonance imaging (DWI) is widely used for diagnosing liver disease, it has not yet been utilized for ... ...

Abstract	Acute cellular rejection (ACR) is a significant immune issue among recipients following liver transplantation. Although diffusion-weighted magnetic resonance imaging (DWI) is widely used for diagnosing liver disease, it has not yet been utilized for monitoring ACR in patients after liver transplantation. Therefore, the aim of this study was to evaluate the efficacy of DWI in monitoring treatment response among recipients with ACR. This study enrolled 25 recipients with highly suspected ACR rejection, and all subjects underwent both biochemistry and DWI scans before and after treatment. A pathological biopsy was performed 4 to 24 h after the first MRI examination to confirm ACR and degree of rejection. All patients were followed up and underwent a repeated MRI scan when their liver function returned to the normal range. After data acquisition, the DWI data were post-processed to obtain the apparent diffusion coefficient (ADC) map on a voxel-by-voxel basis. Five regions of interest were identified on the liver parenchyma to measure the mean ADC values from each patient. Finally, the mean ADC values and biochemical markers were statistically compared between ACR and non-ACR groups. A receiver operating characteristic (ROC) curve was constructed to evaluate the performance of the ADC and biochemical data in detecting ACR, and correlation analysis was used to understand the relationship between the ADC values, biochemical markers, and the degree of rejection. The histopathologic results revealed that 20 recipients had ACR, including 10 mild, 9 moderate, and 1 severe rejection. The results demonstrated that the ACR patients had significantly lower hepatic ADC values than those in patients without ACR. After treatment, the hepatic ADC values in ACR patients significantly increased to levels similar to those in non-ACR patients with treatment. The ROC analysis showed that the sensitivity and specificity for detecting ACR were 80% and 95%, respectively. Furthermore, the correlation analysis revealed that the mean ADC value and alanine aminotransferase level had strong and moderate negative correlation with the degree of rejection, respectively (r = -0.72 and -0.47). The ADC values were useful for detecting hepatic ACR and monitoring treatment response after immunosuppressive therapy.
Language	English
Publishing date	2024-04-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics14080807
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Article ; Online: Drug-Eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma: The Effectiveness of Different Particle Sizes in Downstaging and Bridging in Living Donor Liver Transplantation.

Lim, Wei-Xiong / Sim, Kuan Siong / Chen, Chao-Long / Ou, Hsin-You / Yu, Chun-Yen / Cheng, Yu-Fan

Transplantation proceedings

2024 Volume 56, Issue 3, Page(s) 596–601

Abstract: Aim: To compare the effectiveness of drug-eluting bead transarterial chemoembolization (DEB-TACE) with different particle sizes in bridging and downstaging in pretransplant hepatocellular carcinoma patients. Assess the recurrent and survival rates after ...

Abstract	Aim: To compare the effectiveness of drug-eluting bead transarterial chemoembolization (DEB-TACE) with different particle sizes in bridging and downstaging in pretransplant hepatocellular carcinoma patients. Assess the recurrent and survival rates after living donor liver transplantation (LDLT). Methods: Retrospective review of 580 patients who underwent TACE using DEB from August 2012 to June 2020 at Taiwan Kaohsiung Chang Gung Memorial Hospital. Pre- and post-TACE computed tomography scan images of the liver were reviewed, and treatment responses were assessed using modified Response Evaluation Criteria in Solid Tumors criteria. Patients were divided by who met the criteria (n = 342) or beyond (n = 238) the University of California San Francisco criteria for successful bridging and downstaging rate evaluation. Each group was divided into subgroups according to DEB particle sizes (group A: <100μm, group B: 100-300 μm, group C: 300-500 μm, and group D: 500-700 μm) to compare objective response rate and post-LDLT survival rate. Results: Overall successful bridging and downstaging rate is 97.1% and 58.4%, respectively, in the group of patients who meet the criteria (n = 332) and are beyond (n = 139) the University of California San Francisco criteria. Group B (100-300 μm) had a higher successful bridging rate (99.5%, P = .003) and downstaging rate (63.8%, P = .443). This subgroup also demonstrated a higher objective response rate in single (93.2%, P = .038) tumors, multiple (83.3%, P = .001) tumors, and tumors with size less than 5 cm (93.9%, P = .005). There are no significant differences in post-LDLT overall survival rate between different particle sizes. Conclusion: TACE with 100 to 300 μm DEB particles is associated with a better chance of bridging and downstaging hepatocellular carcinoma patients to LDLT.
MeSH term(s)	Humans ; Carcinoma, Hepatocellular/therapy ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/mortality ; Liver Neoplasms/therapy ; Liver Neoplasms/pathology ; Liver Neoplasms/mortality ; Chemoembolization, Therapeutic ; Liver Transplantation ; Retrospective Studies ; Male ; Female ; Middle Aged ; Living Donors ; Particle Size ; Treatment Outcome ; Adult ; Neoplasm Staging ; Microspheres ; Aged
Language	English
Publishing date	2024-03-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2024.01.062
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Article: AFP Response to Locoregional Therapy Can Stratify the Risk of Tumor Recurrence in HCC Patients after Living Donor Liver Transplantation.

Chen, I-Hsuan / Hsu, Chien-Chin / Yong, Chee-Chien / Cheng, Yu-Fan / Wang, Chih-Chi / Lin, Chih-Che / Chen, Chao-Long

Cancers

2023 Volume 15, Issue 5

Abstract: 1) Background: Alpha-fetoprotein (AFP) has been incorporated into the selection criteria of liver transplantation and been used to predict the outcome of hepatocellular carcinoma (HCC) recurrence. Locoregional therapy (LRT) is recommended for bridging ... ...

Abstract	(1) Background: Alpha-fetoprotein (AFP) has been incorporated into the selection criteria of liver transplantation and been used to predict the outcome of hepatocellular carcinoma (HCC) recurrence. Locoregional therapy (LRT) is recommended for bridging or downstaging in HCC patients listed for liver transplantation. The aim of this study was to evaluate the effect of the AFP response to LRT on the outcomes of hepatocellular carcinoma patients after living donor liver transplantation (LDLT). (2) Methods: This retrospective study included 370 HCC LDLT recipients with pretransplant LRT from 2000 to 2016. The patients were divided into four groups according to AFP response to LRT. (3) Results: The nonresponse group had the worst 5-year cumulative recurrence rates whereas the complete-response group (patients with abnormal AFP before LRT and with normal AFP after LRT) had the best 5-year cumulative recurrence rate among the four groups. The 5-year cumulative recurrence rate of the partial-response group (AFP response was over 15% lower) was comparable to the control group. (4) Conclusions: AFP response to LRT can be used to stratify the risk of HCC recurrence after LDLT. If a partial AFP response of over 15% declineis achieved, a comparable result to the control can be expected.
Language	English
Publishing date	2023-03-01
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15051551
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Article ; Online: Correction: Use of blood oxygen level-dependent magnetic resonance imaging to detect acute cellular rejection post-liver transplantation.

Chiang, Hsien-Jen / Chou, Ming-Chung / Chuang, Yi-Hsuan / Li, Chun-Wei / Lin, Chih-Che / Eng, Hock-Liew / Chen, Chao-Long / Cheng, Yu-Fan

European radiology

2023 Volume 33, Issue 10, Page(s) 7355

Language	English
Publishing date	2023-05-22
Publishing country	Germany
Document type	Published Erratum
ZDB-ID	1085366-2
ISSN	1432-1084 ; 0938-7994 ; 1613-3749
ISSN (online)	1432-1084
ISSN	0938-7994 ; 1613-3749
DOI	10.1007/s00330-023-09670-5
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Article: Proton beam therapy for downstaging hepatocellular carcinoma with lobar portal vein tumor thrombosis to living donor liver transplantation.

Chen, Chao-Long / Dungca, Leona Bettina P / Yong, Chee-Chien / Chen, Itsuko Chih-Yi / Cheng, Yu-Fan / Cheng, Jen-Yu / Chen, Yen-Yang

Hepatobiliary surgery and nutrition

2023 Volume 12, Issue 6, Page(s) 966–974

Language	English
Publishing date	2023-11-15
Publishing country	China (Republic : 1949- )
Document type	Editorial
ZDB-ID	2812398-0
ISSN	2304-389X ; 2304-3881
ISSN (online)	2304-389X
ISSN	2304-3881
DOI	10.21037/hbsn-23-410
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Article ; Online: Portal Dynamics After Living Donor Liver Transplant in Pediatric Recipients: A 10-Year Follow-Up Retrospective Study.

Chen, Chi-Cheng / Ou, Hsin-You / Tsang, Leo Leung-Chit / Cheng, Yu-Fan / Chen, Chao-Long / Chen, Tai-Yi

Transplantation proceedings

2023 Volume 55, Issue 7, Page(s) 1638–1643

Abstract: Background: It may be difficult for pediatric patients to evaluate the impact of liver transplantation (LT) on splenomegaly due to the natural growth course. The long-term dynamics of portal vein (PV) size and PV flow after LT in pediatric patients are ... ...

Abstract	Background: It may be difficult for pediatric patients to evaluate the impact of liver transplantation (LT) on splenomegaly due to the natural growth course. The long-term dynamics of portal vein (PV) size and PV flow after LT in pediatric patients are unclear. We aimed to evaluate the long-term transition of the splenic size, PV size, and PV flow velocity in pediatric patients who underwent successful living donor liver transplantation (LDLT) and survived >10 years. Methods: From October 2004 to December 2010, 39 pediatric patients (25 boys; 14 girls) underwent LDLT, received pre-LDLT and post-LDLT computed tomography scans and long-term ultrasound sonography follow-up, and survived >10 years without additional intervention at our institution. We analyzed the short- to mid-term and long-term impact of LDLT on splenic size, PV size, and PV flow velocity over time. Results: The PV diameter increased throughout the 10-year follow-up (P < .001). The PV flow velocity increased 1 day after LDLT (P< .001); proceeded to decrease 3 days after LDLT, reaching a low point 6 to 9 months after LDLT; and remained stable throughout the 10-year follow-up. Regression of the splenic volume at 6 to 9 months after LDLT (P < .001) was noted. However, the splenic size steadily increased on long-term follow-up. Conclusions: Although LDLT has a significant short-term reduction effect on splenomegaly, the long-term transitional trend of the splenic size and PV diameter may increase along with children's growth. The PV flow reached a stable status 6 to 9 months after LDLT and remained so until 10 years after LDLT.
MeSH term(s)	Male ; Female ; Child ; Humans ; Liver Transplantation/adverse effects ; Liver Transplantation/methods ; Follow-Up Studies ; Living Donors ; Retrospective Studies ; Splenomegaly/diagnostic imaging ; Splenomegaly/etiology ; Splenomegaly/surgery ; Portal Vein/diagnostic imaging ; Portal Vein/surgery ; Treatment Outcome
Language	English
Publishing date	2023-06-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2023.03.090
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Article ; Online: Sarcopenia Affects Liver Regeneration and Long-Term Survival Rate After Living-Donor Liver Transplantation in Patients With Hepatocellular Carcinoma.

Wu, Mei-Yun / Yeh, Cheng-Hsi / Liao, Chien-Chang / Chen, Chao-Long / Wang, Chih-Chi / Lin, Chih-Che / Chang, Wan-Ching / Cheng, Yu-Fan / Ou, Hsin-You

Transplantation proceedings

2024 Volume 56, Issue 3, Page(s) 573–580

Abstract: Purpose: Despite technological and immunologic innovations, some living-donor liver transplant (LDLT) recipients still face poor liver regeneration. Sarcopenia is often recognized as a biomarker for poor outcomes in surgical patients. This study aimed ... ...

Abstract	Purpose: Despite technological and immunologic innovations, some living-donor liver transplant (LDLT) recipients still face poor liver regeneration. Sarcopenia is often recognized as a biomarker for poor outcomes in surgical patients. This study aimed to evaluate associations between sarcopenia and liver regeneration in LDLT recipients. Materials and methods: This retrospective review included consecutive patients who had received LDLT at Chang Gung Memorial Hospital between 2005 and 2017. Sarcopenia was assessed using the psoas muscle index (PMI) in cross-sectional images. Receiver operating characteristic curve analysis was used to determine the ability of PMI to predict relatively poor survival rates. Correlations between liver regeneration and sarcopenia were evaluated using regression analysis. Results: A total of 109 LDLT recipients were included. The 1-, 3-, 5, 10-, and 15-year survival rates were 93.7%, 84.8%, 79.7%, 74.7%, and 73.3% in males and 93.3%, 83.3%, 83.3%, 71.4%, and 71.4% in females. PMIs were significantly different based on 10- and 15-year overall survival rates (P = .001 and P = .000) in male patients. Receiver operating characteristic curve analysis revealed the PMI cutoff point at 6.7 cm Conclusions: Sarcopenia and low PMI are associated with poor liver regeneration and long-term survival after LDLT in male patients. Further studies, including sarcopenia with conventional scores, may help to more reliably predict liver regeneration and mortality among LDLT patients with hepatocellular carcinoma.
MeSH term(s)	Humans ; Sarcopenia/mortality ; Liver Transplantation ; Male ; Female ; Living Donors ; Retrospective Studies ; Middle Aged ; Liver Neoplasms/surgery ; Liver Neoplasms/mortality ; Carcinoma, Hepatocellular/surgery ; Carcinoma, Hepatocellular/mortality ; Liver Regeneration ; Adult ; Survival Rate
Language	English
Publishing date	2024-02-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2023.12.008
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Article ; Online: Imaging Diagnosis of Biliary Complications of ABO Incompatibility in Living Donor Liver Transplantation.

Wang, Cheng-Kang / Cheng, Yu-Fan / Chen, Chao-Long / Ou, Hsin-You

Transplantation proceedings

2020 Volume 52, Issue 6, Page(s) 1833–1837

Abstract: Background: To evaluate the imaging findings of biliary complications in patients with ABO-incompatible (ABOi) living donor liver transplantation (LDLT), with emphasis on ultrasound and magnetic resonance cholangiography results, and to evaluate ... ...

Abstract	Background: To evaluate the imaging findings of biliary complications in patients with ABO-incompatible (ABOi) living donor liver transplantation (LDLT), with emphasis on ultrasound and magnetic resonance cholangiography results, and to evaluate clinical outcomes METHODS: The hospital's Institutional Review Committee on Human Research approved the study protocol, and all of the participants or their guardians provided written informed consent. We performed a retrospective analysis of 33 patients with ABOi LDLT from December 2009 to April 2018 enrolled in the study. After LDLT, patients were followed up daily during the admission period and every visit to the outpatient clinic following discharge. Magnetic resonance cholangiopancreatography (MRCP) was scheduled if ultrasound imaging results or clinical presentation suggested biliary complications. The types of biliary complications on MRCP were classified into nonanastomosis and anastomotic stenosis. Different interventions were arranged according to clinical conditions. Results: Of 33 patients enrolled, 4 patients were found to have abnormal ultrasound findings (12%), 10 patients had elevated liver function (30%), and 1 showed both of them (3%). Fifteen patients received MRCP in the study. Nonanastomosis strictures were found in 5 patients who received different treatment according to clinical conditions, and anastomosis strictures were found in 7 patients who received endoscopic retrograde biliary drainage treatment only. The diagnosis accuracy percentages of biliary complications by ultrasound and MRCP were 66% and 100%, respectively. Conclusion: Doppler ultrasound could made a misdiagnosis in biliary complications. Magnetic resonance cholangiography is necessary if we suspect biliary complications. In addition, the differential diagnosis of biliary complications is mandatory for interventional procedures.
MeSH term(s)	Adult ; Biliary Tract Diseases/diagnostic imaging ; Biliary Tract Diseases/etiology ; Blood Group Incompatibility/complications ; Cholangiopancreatography, Magnetic Resonance/methods ; Female ; Humans ; Liver Transplantation/adverse effects ; Liver Transplantation/methods ; Living Donors ; Male ; Middle Aged ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/etiology ; Retrospective Studies ; Ultrasonography/methods
Language	English
Publishing date	2020-05-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2020.02.133
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Article ; Online: Characteristics and etiologies of hepatocellular carcinoma in patients without cirrhosis: When East meets West.

Yen, Yi-Hao / Cheng, Yu-Fan / Wang, Jing-Houng / Lin, Chih-Che / Wang, Chih-Chi

PloS one

2021 Volume 16, Issue 1, Page(s) e0244939

Abstract: Background/aims: A recent study from the United States reported that nearly 12% of hepatocellular carcinomas (HCCs) occurred in patients without cirrhosis. Non-alcoholic fatty liver disease (NAFLD) was the most common liver disease in these patients. We ...

Abstract	Background/aims: A recent study from the United States reported that nearly 12% of hepatocellular carcinomas (HCCs) occurred in patients without cirrhosis. Non-alcoholic fatty liver disease (NAFLD) was the most common liver disease in these patients. We aim to evaluate the characteristics, etiologies, and outcomes of cases of non-cirrhotic HCC in East Asia, where there is a higher prevalence of hepatitis B virus (HBV)-associated non-cirrhotic HCC. Methods: This retrospective study consecutively enrolled de novo HCC patients managed at our institution from 2011 to 2017. The presence of cirrhosis was assessed by histology; if histology was not available, it was assessed by image study. Results: 2055 patients with HCC were enrolled in this study. Among them, 529 (25.7%) were non-cirrhotic. The non-cirrhotic patients were younger (60.9 vs. 62.5 years, p = 0.006), included a greater proportion of males (78.1% vs. 71.3%, p = 0.002), and had a lower body mass index (24.3 vs. 25.3 kg/m2, p<0.001) than the cirrhotic patients. Among the non-cirrhotic patients, HBV was the most common liver disease (49.0%). The patients with non-cirrhotic HCC had larger tumors (5.9 vs. 4.7 cm, p<0.001), underwent liver resection at a higher rate (66.0% vs. 17.4%, p<0.001), and had better overall survival than the cirrhotic HCC patients (median 5.67 vs. 2.83 years, p<0.001). Conclusions: Nearly 26% of the HCCs occurred in patients without cirrhosis. HBV was the most common liver disease in these patients, and the survival was better in the non-cirrhotic patients than the cirrhotic patients.
MeSH term(s)	Adult ; Carcinoma, Hepatocellular/complications ; Carcinoma, Hepatocellular/epidemiology ; Carcinoma, Hepatocellular/etiology ; Carcinoma, Hepatocellular/therapy ; Female ; Humans ; Liver Cirrhosis/complications ; Liver Neoplasms/complications ; Liver Neoplasms/epidemiology ; Liver Neoplasms/etiology ; Liver Neoplasms/therapy ; Male ; Middle Aged ; Prevalence ; Retrospective Studies
Language	English
Publishing date	2021-01-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0244939
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