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Invasive breast carcinoma with osteoclast-like stromal giant cells:A case report

World Journal of Clinical Cases 2023年第7期11卷 1521-1527页

作者： Yi-Jie Wang Chien-Peng Huang Zhi-Jie Hong Guo-Shiou Liao jyh-cherng yu Department of Surgery Tri Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Department of Pathology Tri Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Division of Traumatology Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Division of General Surgery Department of SurgeryTri Service General HospitalNational Defense Medical CenterTaipei 114Taiwan

BACKGROUND Invasive breast carcinoma with osteoclast-like stromal giant cells(OGCs) is an extremely rare morphology of breast *** the best of our knowledge,the most recent case report describing this rare pathology was published six years *** mechanism controlling the development of this unique histological formation is still ***,the prognosis of patients with OGC involvement is also *** SUMMARY We report the case of a 48-year-old woman,who presented to the outpatient department with a palpable,growing,painless mass in her left breast for about one *** and mammography revealed a 26.5 mm ×18.8 mm asymmetric,lobular mass with circumscribed margin and the Breast Imaging Reporting and Data System was category ***-guided aspiration biopsy revealed invasive ductal *** patient underwent breast conserving surgery and was diagnosed with invasive breast carcinoma with OGCs,grade Ⅱ,with intermediate grade of ductal carcinoma in situ(ER:80%,3+,PR:80%,3+,HER-2:negative,Ki 67:30%).Adjuvant chemotherapy and post-operation radiotherapy were initiated *** As a rare morphology of breast cancer,breast carcinoma with OGC occurs most often in relatively young women,has less lymph node involvement,and its occurrence is not racedependent.

关键词： Breast carcinoma Osteoclast stromal giant cell Pathology Histochemical stains Prognosis Case report

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Cystic lymphangioma of the jejunal mesentery in an adult: A case report

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World Journal of Gastroenterology 2005年第32期11卷 5084-5086页

作者： Sheng-Der Hsu Chien-Hua Lin jyh-cherng yu Division of General SurgeryDepartment of Surgery Department of PathologyTri-Service General HospitalTaipeiTaiwanChina

We herein describe the case of a 27-year-old female, who presented with a large mass of the upper left abdominal cavity discovered incidentally, through an annual health examination. Preoperative studies including abdominal ultrasonography and magnetic resonance imaging were performed, but they could not accurately determine the nature of the tumor. At laparotomy, a large cystic tumor of the small bowel mesentery was found. Histopathologic examination diagnosed the tumor as a cystic *** lymphangiomas are rare, especially in the abdomen of adults, they may sometimes present as acute abdomen,causing complications that require emergent surgery.

关键词： Jejunum Lymphangioma Small bowel mesentery

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Intrauterine contraceptive device appendicitis: A case report

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World Journal of Gastroenterology 2005年第34期11卷 5414-5415页

作者： Chung-Bao Hsieh Chung-Jueng Chen jyh-cherng yu Division of General Surgery Department of Surgery Tri-Service General Hospital National Defense Medical Center Taipei Taiwan China

Uterine perforation is one of the serious complications associated with use of the intrauterine contraceptive device （IUD）. Uterine perforaUon by IUD can involve several neighboring organs. A case of acute appendicitis was caused by a Multiload Cu 375 TUD inserted previously. This is a rare complication and only fourteen previous cases were recorded in the literature.

关键词： Appendidcitis Intrauterine contraceptive device Uterine perforation

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Sclerosing encapsulating peritonitis in a liver transplant patient: A case report

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World Journal of Gastroenterology 2005年第34期11卷 5412-5413页

作者： Chien-Hua Lin jyh-cherng yu Cheng-Jueng Chen Chung-Bao Hsieh Division of General Surgery Department of Surgery Tri-Service General Hospital National Defense Medical Center Taipei Taiwan China

We report a patient with HBV-related hepatocellular carcinoma （HCC） and refractory ascites who had received a peritoneal-venous shunt （PVS） 1 year before liver transplantation, Urgent surgical intervention following bowel obstruction and failure of immunosuppression therapy. No intestinal obstruction was found during an initial PVS. However, intestinal obstruction developed 2 was found upon exploration. This is the first reported case of cocoon abdomen caused by PVS and exacerbated by liver transplantation.

关键词： Sclerosing encapsulating peritonitis Cocoon abdomen Intestinal obstruction Liver transplantation

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Ruptured hepatoblastoma with massive internal bleeding in an adult

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World Journal of Gastroenterology 2005年第39期11卷 6235-6237页

作者： Hung-Yen Ke Yee-Min Jen jyh-cherng yu Chung-Bao Hsieh Cheng-Jueng Chen Division of General Surgery Department of Surgery Department of Radio-OncologyTri-Service General HospitalNational Defense Medical CenterTaipeiTaiwanChina

Hepatoblastoma is the most common primary hepatic tumor of children. However, only a very few cases have been reported in adults. Most studies support treatment with chemotherapy followed by surgical resection. We present the first reported case of adult hepatoblastoma in Taiwan. A 52-year-old female suffered from sudden onset of abdominal pain and general weakness for *** bleeding with hemorrhagic shock was suspected and two massive lesions in both lobes of the liver with hemoperitoneum were noted from imaging *** resection of the larger left lobe tumor and radio-frequency ablation of the right smaller one were performed. The histopathology diagnosis was of a hepatoblastoma.

关键词： Adult hepatoblastoma Hepatoblastoma rupture Internal bleeding Hepatoblastoma Mixed type hepatoblastoma

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Knot formation in the feeding jejunostomy tube:A case report and review of the literature

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World Journal of Gastroenterology 2007年第6期13卷 973-974页

作者： Guo-Shiou Liao Huan-Fa Hsieh Meng-Hang Wu Teng-Wei Chen jyh-cherng yu Yao-Chi Liu Department of Surgery Tri-Service General Hospital Penghu Branch National Defense Medical Center Taiwan China Division of General Surgery Department of Surgery Tri-Service General Hospital National Defense Medical Center Taipei Taiwan China Department of Surgery Yee-Zen General Hospital Taiwan China Department of Surgery Show Chwan Memorial Hospital Changhua Taiwan China

Jejunostomy feeding tubes provide surgeons with an excellent method for providing nutritional support, but there are several complications associated with a tube jejunostomy, including complications resulting from placement of the tube, mechanical problems related to the location or function and development of focally thickened small-bowel folds. A 76-year old man who presented with multiple medical diseases was admitted to our hospital due to aspiration pneumonia with acute respiratory failure and septic shock. He underwent exploratory laparotomy with feeding jejunostomy using a 14-French nasogastric tube for nutritional support. However, occlusion of the feeding tube was found 30 d after operation, and a rare complication of knot formation in the tube occurred after a new tube was replaced. On the following day, the tube was removed and replaced with a similar tube, which was placed into the jejunum for only 15 cm. The patient's feedings were maintained smoothly for two months. Knot formation in the feeding tube seems to be very rare. To our knowledge, this is the third case in the literature review. Its incidence is probably related to the length of the tube inserted into the lumen.

关键词： Feeding jejunostomy tube Complications Knot formation

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Helicobacter pylori infection in relation to E-cadherin gene promoter polymorphism and hypermethylation in sporadic gastric carcinomas

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World Journal of Gastroenterology 2005年第33期11卷 5174-5179页

作者： Yao-Chi Liu Chen-Yang Shen Hurng-Sheng Wu De-Chuan Chan Cheng-Jueng Chen jyh-cherng yu Cheng-Ping yu Horng-jyh Harn Rong-Yaun Shyu yu-Lueng Shih Chung-Bao Hsieh Huan-Mieng Hsu Division of General Surgery Department of Surgery Tri-Service General HospitalNational Defense Medical Center Taipei Taiwan China Division of Gastroenterology Department of Internal Medicine Tri-Service General HospitalNational Defense Medical Center Taipei Taiwan China Department of Pathology Tri-Service GeneralHospital National Defense Medical Center Taipei Taiwan China Department of Pathology Buddhist Tzu-Chi General Hospital Hualien Taiwan China Department of Surgery Show Chwan Memorial Hospital Changhua Taiwan China Institute of Biomedical Sciences Academia Sinica Taipei Taiwan China

AIM: To study Helicobacter pylori (H pylori) infection in relation to E-cadherin (E-cad) promoter polymorphism and hypermethylation in ***: Specimens were taken from representative cancerous lesions and adjacent non-cancerous epithelia of 67 resected GCs. Hpyloriwas detected by real-time PCR of the cagA gene from non-neoplastic epithelium.E-cad promoter polymorphism and hypermethylation were determined by restriction fragment length polymorphism analysis and methylation-specific PCR, respectively. Expression of E-cad protein was determined by ***: Hpyloriwas found in 57% of patients with GC.H pylori infection was more frequently found in tumors with the -160C/C genotype than those with the -160C/A and -160A/A genotypes (74% vs47%, P = 0.02). Hpylori infection was associated with E-cad methylation in nonneoplastic epithelium; however, no significant difference in H pylori was observed between methylated and unmethylated cancerous ***: Patients with the -160C/C genotype might require Hpyloriinfection to promote the inactivation of CDH1, suggesting that Hpylori infection might affect GC in an initial stage because polymorphism is germ *** of hypermethylation of CDH1 promoter in GC is complex, and Hpyloriinfection might affect it in an initial stage.

关键词： H pylort E-cadherirr -160 C→A polymorphism Hypermethylation Gastric carcinoma

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Leukemoid Reaction as a “Tumor Marker” in Breast Cancer

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Surgical Science 2012年第5期3卷 271-273页

作者： Chien-Hua Lin jyh-cherng yu Jing-Jim Ou yueh-Tsung Lee Hurng-Sheng Wu Department of Surgery Chang-Bing Show Chwan Memorial Hospital Changhua Chinese Taipei Division of General Surgery Department of Surgery Tri-Service General Hospital Taipei Chinese Taipei

Neutrophilic leukocytosis above 50 × 109/l exclude leukemia, defines a leukemoid reaction (LR). It is associated with several diseases. Although it simulates leukemia, most of the causes are benign. Tumor-related LR is more common. It is associated with ranulocyte colony-stimulating factor (G-CSF) secreted by the tumor cells. A 38-year-old woman, presented with advanced breast cancer and leukocytosis (79.9 × 103/uL) was found. After completion of MRM, the condition of leukocytosis subsided. Two months later, tumor local relapse was found and white blood cells (WBC) rose again. After completion of wide excision, the condition of leukocytosis subsided again. We think this case was associated with leukemoid reaction.

关键词： Leukemoid Reaction Leukocytosis Breast Cancer

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Mechanisms inactivating the gene for E-cadherin in sporadic gastric carcinomas

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World Journal of Gastroenterology 2006年第14期12卷 2168-2173页

作者： Yao-Chi Liu Chen-Yang Shen Hurng-Sheng Wu Tsai-yuan Hsieh De-Chuan Chan Cheng-Jueng Chen jyh-cherng yu Cheng-Ping yu Horng-jyh Harn Peng-Jen Chen Chung-Bao Hsieh Teng-Wei Chen Huan-Mieng Hsu Division of General Surgery Department of Surgery Tri-Service General Hospital National Defense Medical Center Taipei Taiwan China Division of Gastroenterology Department of Internal Medicine Tri-Service General Hospital National Defense Medical Center Taipei Taiwan China Department of Pathology Tri-Scrvice General Hospital National Defense Medical Center Taipei Taiwan China Department of Pathology Buddhist Tzu-Chi General Hospital Hualien Taiwan China Department of Surgery Show Chwan Memorial Hospital Changhua Taiwan China Institute of Biomedical Sciences Academia Sinica Taipei Taiwan China

AIM： To study the role of CDH1/E-cadherin （E-cad） gene alteration profiles including mutation, loss of heterozygosity （LOH）, promoter polymorphism and hypermethylation in mechanisms of CDH1 inactivation in gastric carcinoma （GC）. METHODS： Specimens were collected surgically from 70 patients with GC. Allelotyping PCR and detection of LOH, denaturing high pressure liquid chromatography and DNA sequencing, restriction fragment length polymorphism analysis, methylation specific PCR, and immunohistochemical staining were used. RESULTS： Promoter polymorphism was not a major mechanism of E-cad inactivation. Only one truncating mutation was found in a diffuse type tumor （3%）. Both LOH and promoter hypermethylation were major mechanisms of E-cad inactivation, but interestingly, there was a negative association between the fraction of allelic loss （LOH） in tumors and hypermethylation of CDH1. Therefore LOH and hypermethylation were two different tumorigenic pathways involved in GC. CONCLUSION： Given the findings that somatic mutation was extremely low and the relationship between LOH and hypermethylation was inverse, any two combinations of these three factors cannot fulfill the classical two-hit hypothesis of CDH1 inactivation. Thus, other mechanisms operating at the transcriptional level or at the post-translational level might be required to induce E-cadherin inactivation.

关键词： Gastric carcinoma E-cadherin gene alteration profiles Inactivation of E-cadherin

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Chilaiditi Syndrome: The Pitfalls of Diagnosis

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Surgical Science 2012年第3期3卷 141-144页

作者： Chien-Hua Lin jyh-cherng yu Jing-Jim Ou yueh-Tsung Lee Mei Huang Hurng-Sheng Wu Department of Medicine Chang-Bing Show Chwan Memorial Hospital Changhua Chinese Taipei Division of General Surgery Department of Surgery Tri-Service General Hospital Taipei Chinese Taipei General Surgery Department Chang-Bing Show Chwan Memorial Hospital Changhua Chinese Taipei IRCAD Taiwan Chang-Bing Show Chwan Memorial Hospital Changhua Chinese Taipei

Purpose: Chilaiditi’s syndrome is the hepatodiaphragmatic interposition of the colon. Its diagnosis poses challenge to clinicians, and misdiagnosis may results in unnecessary exploratory laparotomy being performed. The purpose of this study was to report our experience in diagnosis, management, and clinical outcome of patients with Chilaiditi’s syndrome. Methods: Nine cases of Chilaiditi’s syndrome from April 2005 to January 2007 at one institute. The clinical characteristic, imaging studies, management and results were recorded. Results: Six patients presented with abdominal distension (2 patients with abdominal pain;5 patients with constipation), while Chilaiditi’s syndrome in the other three patients were found incidentally. All patients underwent chest X-ray. The Chilaiditi’s sign could be detected in seven patients;while the other two patients presented with no specific finding. Abdominal plain films (KUB) were all reviewed. Most of the patients (n = 8) showed ileus and one patient showed no specific finding. Impacted stool could be detected in five of nine patients. Abdominal ultrasound was performed in two patients. Gallstones were detected in one of them while the other revealed no specific finding. Six of nine patients underwent CT of abdomen, one of them revealed bowel loops in bilateral subphrenic space. One patient underwent subtotal colectomy because of volvulus of sigmoid colon. Five patients were treated with laxative and enema successfully and had been remained asymptomaticcally for a mean follow-up of 6.6 months. The other three cases were under observation. Conclusions: Presence of haustral folds of bowel loops may help us in diagnosing Chilaiditi’s syndrome. The left lateral decubitus abdominal plain film can also help to differentiate between pneumoperitoneum to Chilaiditi’s sign. Most of the cases with Chilaiditi’s syndrome can be resolved with conservative treatment and surgical intervention was reserved for patients with sign of systemic toxic

关键词： Chilaiditi Syndrome Hepatodiaphragmatic Interposition Chilaiditi

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