Xiao-Jun Wei, Ph.D., M.D.

Diagnostic pitfalls in fine needle aspiration biopsy of the spleen
Friedlander, Maria A; Wei, Xiao-Jun; Iyengar, Pratibha; Moreira, Andre L
2008 Feb;36(2):69-75, Diagnostic cytopathology
Fine needle aspiration (FNA) of the spleen is rarely performed, due to fear of procedure complications. The objective of this study is to review the cytologic diagnoses of aspiration biopsy of the spleen performed in a cancer center.Archival material (9-year period) was reviewed and correlated with histologic and ancillary test results, when available.Forty-one splenic FNA specimens were identified. There were no reported procedure complications. Nineteen cases were diagnosed as malignant. Of these, 11 were lymphomas. Nineteen cases were diagnosed as benign. There was one false-negative case and four false-positive cases. Primary splenic neoplasms were rare and misinterpreted as malignant.It is important to be familiar with the normal cytology of this uncommonly aspirated organ in order to successfully identify neoplastic and malignant processes. The use of ancillary studies is important in the definitive classification of benign and malignant splenic lesions
— id: 94285, year: 2008, vol: 36, page: 69, stat: Journal Article,

Ependymomas of the central nervous system and adult extra-axial ependymomas are morphologically and immunohistochemically distinct--a comparative study with assessment of ovarian carcinomas for expression of glial fibrillary acidic protein
Idowu, Michael O; Rosenblum, Marc K; Wei, Xiao-Jun; Edgar, Mark A; Soslow, Robert A
2008 May;32(5):710-718, American journal of surgical pathology
Extra-axial ependymomas are very rare but have been reported in the ovary, broad ligament, sacrococcygeal region, lung, and mediastinum. The histogenesis is obscure, and a thorough immunohistochemical analysis is lacking. We reviewed the morphologic and immunohistochemical features of 5 extra-axial ependymomas occurring in adults, 1 arising in an infantile sacrococcygeal teratoma, and a control group of 10 central nervous system (CNS) ependymomas in adults. All cases were evaluated for expression of epithelial membrane antigen, estrogen receptor (ER), progesterone receptor (PR), WT1, CD99, CK18, AE1:3, CAM 5.2, 34betaE12, CK7, CK20, synaptophysin, chromogranin, and glial fibrillary acidic protein (GFAP) using formalin-fixed, paraffin-embedded tissue. One hundred twelve ovarian carcinomas in 3 tissue microarrays were also studied with GFAP. The adult extra-axial cases demonstrated more architectural variability than the CNS cases. We observed that both the CNS and adult extra-axial ependymomas expressed GFAP diffusely, whereas only 9 stage III, high-grade ovarian serous papillary carcinomas stained with GFAP (2 strongly and diffusely and 7 exhibiting focally weak expression). There were significant immunophenotypic differences between adult extra-axial and CNS ependymomas, with extra-axial cases preferentially expressing 34betaE12 (60% vs. 0%), CK18 (100% vs. 20%), CAM 5.2 (60% vs. 10%), CK7 (80% vs. 10%), ER (100% vs. 10%), and PR (80% vs. 20%). Two spinal cord ependymomas expressed CK18, 1 expressed CK7, and 1 expressed CAM 5.2. CNS ependymomas more frequently expressed CD99 (100% vs. 20%). The following stains were not differentially expressed: epithelial membrane antigen (expressed in 2 of 15 cases, including both extra-axial and CNS ependymomas), synaptophysin (1/15), chromogranin (0/15), WT1 (8/15), AE1:3 (10/15), and CK20 (0/15). The ependymal elements of the sacrococcygeal tumor failed to express 34betaE12, CK18, CAM 5.2, and CK7, like most CNS ependymomas. The morphologic and immunophenotypic differences between extra-axial and CNS ependymomas suggest that they derive from distinct precursors and/or differentiate along distinct pathways. The differential diagnosis of extra-axial ependymomas is extensive, and GFAP expression in primary ovarian serous carcinomas, although rare, could theoretically contribute to diagnostic difficulties. ER and PR expression in extra-axial ependymomas may provide targets for hormonal therapy
— id: 79419, year: 2008, vol: 32, page: 710, stat: Journal Article,

[Clinical study of 231 cases of radical excision with sphincter preservation by casing anastomosis in low rectal cancer]
Li, Shi-yong; Liang, Zhen-jia; Yuan, Shu-jun; Yu, Bo; Chen, Gang; Chen, Guang; Bai, Xue; Zuo, Fu-yi; Wei, Xiao-jun; Wu, En
2007 Sep 1;45(17):1170-1172, Zhonghua wai ke za zhi = [Chinese journal of surgery]
OBJECTIVE: To investigate the clinical efficacy, feasibility and safety of sphincter-preserving procedure by casing anastomosis of colon and rectal mucosa in low rectal cancer. METHODS: A retrospective analysis was carried out in 231 cases of low rectal cancer performed casing anastomosis. RESULTS: One hundred and ninety-seven (197/231, 85.3%) cases were followed up, the median time of the follow up was 5.9 years (range, 2 months-14 years). Eight (3.4%) cases of stoma leak and 3 (1.2%) cases of stoma stenosis were found post operation. Defecating function recovered normally (1 - 3 times per day) in 12 - 24 weeks after operation in all patients. Local recurrence was found in 5.1% (10/197) of the cases. Hepatic and lung metastasis was found in 15.2% (30/197) and 2.5% (5/197) of the patients, respectively. The five-year survival rate was 71.6% totally. CONCLUSIONS: The casing anastomosis procedure with sphincter preservation is safe and efficacy for low rectal cancer. With the procedure, the anal function can be preserved well, stoma leak is decreased, and the five-year survival rate is the same as Miles operation
— id: 94287, year: 2007, vol: 45, page: 1170, stat: Journal Article,

Fine-needle aspiration biopsy of monophasic variant of spindle epithelial tumor with thymus-like differentiation of the thyroid: report of one case and review of the literature
Tong, Guo-Xia; Hamele-Bena, Diane; Wei, Xiao-Jun; O'Toole, Kathleen
2007 Feb;35(2):113-119, Diagnostic cytopathology
Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a rare biphasic tumor of the thyroid with approximately 20 well-documented cases reported in the English literature. Although a monophasic variant of SETTLE is conceivable, the majority of the reported cases were truly biphasic tumors. A minimal amount of epithelial component was present in the reported cases of so-called spindle-cell predominant SETTLE. Here, we report an apparently monophasic case of SETTLE in a 16-yr-old girl, in which no epithelial cells were identified in either fine-needle aspiration biopsy (FNAB) or the subsequent hemithyroidectomy specimen. The FNAB smears were moderately cellular and composed of single and loosely grouped spindle cells with homogenous metachromatic material, which could be mistaken as amyloid, erroneously suggesting medullary thyroid carcinoma. The compact nodules of uniform spindle cells in histology sections raised the possibility of monophasic synovial sarcoma. The spindle cells stained positive for both cytokeratin and vimentin, but were negative for thyroglobulin and calcitonin as well as neuroendocrine markers, confirming the diagnosis of SETTLE
— id: 73208, year: 2007, vol: 35, page: 113, stat: Journal Article,

[Clinical analysis of therapeutic effects of sphincter-preserving operation and Miles operation for rectal cancer]
Zuo, Fu-yi; Li, Shi-yong; Yu, Bo; Liang, Zhen-jia; Yuan, Shu-jun; Chen, Gang; Chen, Guang; Bai, Xue; Wei, Xiao-jun; Wu, En
2007 Sep 1;45(17):1176-1178, Zhonghua wai ke za zhi = [Chinese journal of surgery]
OBJECTIVE: To investigate and compare therapeutic effects of sphincter-preserving operation and Miles operation for rectal cancer. METHODS: A retrospective analysis was carried out in 572 cases of rectal cancer operations performed from January 1980 to December 2006. RESULTS: Sphincter-preserving operation was carried out in 403 cases and Miles procedure in 169 cases. The follow-up rate was 76.2% (436/572) with a period of 0.5 - 25.0 years (median, 9.5 years). Local recurrence occurred in 6.3% (20/317) of sphincter-preserving operation and 7.6% (9/119) of Miles operation, the differences was not significant (chi2 = 1.3942, P > 0.05). Distal metastasis was found in 50 cases (15.7%) of sphincter-preserving operation and 19 cases (16.2%) of the Miles operation with no significant difference (chi2 = 0.6672, P > 0.05). There was no significant difference in five-year survival rate between the two groups, with 67.8% in sphincter-preserving operation and 67.2% in Miles operation. CONCLUSIONS: Sphincter-preserving operations can improve the quality of life in rectal cancer although with the same five-year survival rate and recurrence rate as Miles operation. The operation for rectal cancer should be performed individually according to the location, the bionomics and the clinical stage
— id: 94286, year: 2007, vol: 45, page: 1176, stat: Journal Article,

Long-term outcomes of malignant phyllodes tumors patients: an institutional experience
Fou, Adora; Schnabel, Freya R; Hamele-Bena, Diane; Wei, Xiao-Jun; Cheng, Bin; El Tamer, Mahmoud; Klein, Laura; Joseph, Kathie Ann
2006 Oct;192(4):492-495, American journal of surgery
BACKGROUND: Malignant phyllodes tumors are an extremely rare breast tumor. Prognostic features and overall survival data have not been consistent across studies. METHODS: Retrospectively, we examined the clinicopathologic features of 27 breast cancer patients treated for malignant phyllodes tumors from 1995 to 2004 and analyzed their recurrence and survival outcomes using contingency tables, a logistic regression model, or a proportional hazard model. RESULTS: The mortality rate was 12% (n = 3) of the cohort and 75% of the group with distant metastases. The median follow-up period was 51 months (range, 12-192 mo). A mitotic index greater than 10 per high-powered field, the presence of stromal overgrowth, mastectomy at initial surgery, and larger tumor size were associated with an increased incidence of distant metastases. Larger tumor size also was associated with an increased incidence of death. CONCLUSIONS: Most patients with malignant phyllodes tumors will enjoy significant long-term survival if treated appropriately with local excision with clear margins
— id: 73201, year: 2006, vol: 192, page: 492, stat: Journal Article,

Utility of CD10 and RCCma in the diagnosis of metastatic conventional renal-cell adenocarcinoma by fine-needle aspiration biopsy
Simsir, Aylin; Chhieng, David; Wei, Xiao-Jun; Yee, Herman; Waisman, Jerry; Cangiarella, Joan
2005 Jul;33(1):3-7, Diagnostic cytopathology
The cytologic diagnosis of primary conventional renal-cell adenocarcinoma (cRCC) is usually straightforward; however, metastatic cRCC must be distinguished from a variety of neoplasms with clear-cell features. CD10, a cell membrane-associated neutral endopeptidase, and renal-cell carcinoma marker (RCCma), an antibody against human proximal tubular brush border antigen, have recently been shown to be useful in the diagnosis of cRCC. We compared CD10 and RCCma in cell block material from fine-needle aspiration biopsies (FNABs) to assess their utility in the diagnosis of metastatic cRCC, in cytologic specimens. Seven primary and sixteen metastatic cRCCs were immunostained with CD10 and RCCma. The immunoreactivity results were compared with those of a variety of neoplasms originating from other sites such as the liver, lungs, breast, and the gastrointestinal tract. The sensitivity and specificity of CD10 for cRCC were 100% and 59%, respectively. The sensitivity and specificity of RCCma for cRCC were 35% and 100%, respectively. We conclude that CD10 has limited value in confirming the diagnosis of cRCC because of its low specificity. RCCma, when positive, is highly specific for cRCC, but its low sensitivity hinders its diagnostic usefulness. Diagn. Cytopathol. 2005;33:3-7. (c) 2005 Wiley-Liss, Inc
— id: 56162, year: 2005, vol: 33, page: 3, stat: Journal Article,

Differential expression of cytokeratins 7 and 20 and thyroid transcription factor-1 in bronchioloalveolar carcinoma: an immunohistochemical study in fine-needle aspiration biopsy specimens
Simsir, Aylin; Wei, Xiao-Jun; Yee, Herman; Moreira, Andre; Cangiarella, Joan
2004 Mar;121(3):350-357, American journal of clinical pathology
We studied the staining patterns of bronchioloalveolar carcinoma (BAC) with antibodies to cytokeratin (CK) 7, CK20, and thyroid transcription factor-1 (TTF-1) to determine the diagnostic usefulness of this panel in differentiating BAC from metastatic adenocarcinoma in material obtained by fine-needle aspiration biopsy (FNAB) of the lung. We identified 16 cases of BAC. Of these, 6 were mucinous, 4 were nonmucinous, and 6 were mixed with focal mucinous differentiation. Immunohistochemical analysis with antibodies to CK7, CK20, and TTF-1 was performed on cell-block sections. Of the 6 mucinous BACs, 4 (67%) were CK7+, CK20+, and TTF-1-. All 4 nonmucinous BACs were CK7+ and CK20-, and 2 (50%) were TTF-1+. All 6 mixed BACs were diffusely positive for CK7 and focally positive for CK20; 5 (83%) were TTF-1+. Nonmucinous BACs display CK7, CK20, and TTF-1 immunoreactivity similar to conventional pulmonary adenocarcinoma. Mucinous and mixed BACs have an immunohistochemical phenotype that is different from that of conventional pulmonary adenocarcinoma. Knowledge of these staining patterns is crucial for distinguishing mucinous and mixed BACs from metastatic adenocarcinoma involving the lungs
— id: 42578, year: 2004, vol: 121, page: 350, stat: Journal Article,

Comparison of CD10 and renal cell carcinoma marker in diagnosing primary and metastatic renal cell carcinoma on fine needle aspiration biopsy
Cangiarella, J; Wei, XJ; Simsir, A; Yee, H; Chhieng, D
2003 ;83(Suppl 1):61A-61A, Laboratory investigation
— id: 37143, year: 2003, vol: 83, page: 61A, stat: Journal Article,

Comparison of CD10 and renal cell carcinoma marker in diagnosing primary and metastatic renal cell carcinoma on fine needle aspiration biopsy
Cangiarella, J; Wei, XJ; Simsir, A; Yee, H; Chhieng, D
2003 ;16(Suppl 1):61A-61A, Modern pathology
— id: 38513, year: 2003, vol: 16, page: 61A, stat: Journal Article,

Leiomyosarcoma of the breast: A difficult diagnosis on fine-needle aspiration biopsy
Jun Wei, Xiao; Hiotis, Karen; Garcia, Roberto; Hummel Levine, Pascale
2003 Sep;29(3):172-178, Diagnostic cytopathology
Leiomyosarcoma of the breast is rarely encountered in fine-needle aspiration (FNA) cytologic material. We report a case of primary leiomyosarcoma of the breast in a 52-yr-old female. Aspiration cytology showed large, dissociated round to spindle cells with abundant vacuolated cytoplasm, pleomorphic nuclei, prominent nucleoli, and occasional intranuclear cytoplasmic invaginations. Mitotic figures, osteoclast-like giant cells, and stromal fragments were identified. A diagnosis of malignant neoplasm representing either a sarcoma, a poorly differentiated carcinoma, or a metaplastic carcinoma was made. The patient underwent a wide excision of the lesion after negative work-up. Histologic examination and immunohistochemical studies established the diagnosis of leiomyosarcoma. This case is presented here because we feel that, although FNA cytology with eventual ancillary studies is a valuable diagnostic tool to evaluate any breast mass, malignant spindle cell neoplasms of the breast still represent a diagnostic challenge for the cytopathologist. Recognition of all cytologic features of leiomyosarcoma may help to formulate a correct diagnosis. Diagn. Cytopathol. 2003;29:172-178
— id: 37242, year: 2003, vol: 29, page: 172, stat: Journal Article,

Pleomorphic liposarcoma of the uterus: case report and literature review
Levine, Pascale Hummel; Wei, Xiao-Jun; Gagner, Jean-Pierre; Flax, Herschel; Mittal, Khush; Blank, Stephanie V
2003 Nov;22(4):407-411, International journal of gynecological pathology
A 62-year-old woman with a history of breast carcinoma being treated with tamoxifen presented with a rapidly enlarging pelvic mass. Imaging studies suggested a uterine leiomyoma with possible sarcomatous transformation. Laparotomy revealed a 15-cm, oval, well-circumscribed mass emanating from the posterior cervix and left uterosacral ligament. The tumor had a variegated fleshy, tan, myxoid, and necrotic sectioned surface. Microscopic examination revealed a variety of patterns and cell types characteristic of liposarcoma that included myxoid/round cell, storiform/pleomorphic, epithelioid, and spindle cell areas. Lipogenic areas exhibited a 'crow's feet' vasculature and characteristic lipoblasts. The tumor cells were highly pleomorphic with numerous mitotic figures, some of them atypical. The tumor cells were immunoreactive for vimentin, estrogen receptors, and S-100. The tumor recurred 9 months postoperatively. Although a variety of uterine tumors have been associated with tamoxifen treatment, this appears to be the first example of tamoxifen-associated uterine liposarcoma
— id: 46244, year: 2003, vol: 22, page: 407, stat: Journal Article,

Pw1/Peg3 is a potential cell death mediator and cooperates with Siah1a in p53-mediated apoptosis
Relaix, F; Wei, X j; Li, W; Pan, J; Lin, Y; Bowtell, D D; Sassoon, D A; Wu, X
2000 Feb 29;97(5):2105-2110, Proceedings of the National Academy of Sciences of the United States of America
Induction of wild-type p53 in mouse fibroblasts causes cell cycle arrest at the G(1) phase, whereas coexpression of p53 and the protooncogene c-myc induces apoptosis. Although p53 transcriptional activity generally is required for both pathways, the molecular components mediating p53-dependent apoptosis are not well understood. To identify factors that could mediate p53-induced cell death, we used a comparative RNA differential display procedure. We have identified Pw1/Peg3 as a gene product induced during p53/c-myc-mediated apoptosis. Pw1/Peg3 is not induced during p53-mediated G(1) growth arrest nor by c-myc alone. Although it is not clear whether the induction of Pw1/Peg3 depends on p53 activity, we show that Pw1/Peg3 interacts with a p53-inducible gene product Siah1a. We demonstrate that coexpression of Pw1/Peg3 with Siah1a induces apoptosis independently of p53 whereas expression of Pw1/Peg3 or Siah1a separately has no effect on cell death. These data suggest that Siah1a and Pw1/Peg3 cooperate in the p53-mediated cell death pathway. Furthermore, we show that inhibiting Pw1/Peg3 activity blocks p53-induced apoptosis. The observation that Pw1/Peg3 is necessary for the p53 apoptotic response suggests a pivotal role for this gene in determining cell death versus survival
— id: 73249, year: 2000, vol: 97, page: 2105, stat: Journal Article,

Peg3/Pw1 is an imprinted gene involved in the TNF-NFkappaB signal transduction pathway
Relaix, F; Wei, X J; Wu, X; Sassoon, D A
1998 Mar;18(3):287-291, Nature genetics
Tumor necrosis factor (TNF) mediates a variety of biological activities including cell proliferation, differentiation and programmed cell death. The specific response to TNF depends upon cell type and reflects the presence of specific regulatory proteins that participate in the TNF response pathway. TNF signal transduction is mediated by TRAF2 which binds the TNF Receptor2 (TNFR2) and activates NFkappaB. We previously identified a gene Pw1, which encodes a large zinc-finger containing protein. We have determined that Pw1 is identical to Peg3, a paternally expressed gene of unknown function (and will therefore be referred to as Peg3 throughout this text). We report here that Peg3 associates specifically with TRAF2 but not with other TRAF family members. Peg3 expression activates NFkappaB via IkappaB-NFkappaB dissociation and acts synergistically with TRAF2. Transfection of a truncated Peg3 containing the TRAF2 interaction site, abolishes NFkappaB activation by TRAF2 and/or TNF. We conclude that Peg3 is a regulator of the TNF response. These data reveal the involvement of an imprinted gene in this pathway
— id: 73227, year: 1998, vol: 18, page: 287, stat: Journal Article,

Dephosphorylation of Vav is associated with the induction of mouse erythroleukemia cell differentiation: effects of orthovanadate and levamisole
Scher, B M; Wei, X J; Waxman, S; Scher, W
1998 Jun;12(6):1307-1313, International journal of oncology
Mouse erythroleukemia (MEL) cell erythroid differentiation induced by dimethyl sulfoxide or hexamethylene bisacetamide (HMBA) is accompanied by the production of hemoglobin, terminal cell division and decreases in lactate production and fructose 2,6-bisphosphate levels. A number of studies have suggested that decreases in the cellular level of protein phosphotyrosine content may play a role in MEL cell differentiation. In particular, it was shown that the expression of several protein tyrosine phosphatase genes accompany this process and that the transfection of one of these genes into MEL cells followed by its subsequent expression induced eythroid differentiation. However, none of the physiological substrates for these protein tyrosine phosphatases have been identified. It is shown here that MEL cell differentiation is accompanied by decreases in tyrosine phosphorylation of Vav and possibly of the erythropoietin receptor (EpoR). Immunoprecipitation of the EpoR and analysis of co-precipitated proteins, indicates that the EpoR associates with Vav, STAT5 and an unidentified 60 Kd protein, . HMBA-induced erythroid differentiation abrogates these associations. The phosphatase inhibitors, Na3VO4 and levamisole, inhibit HMBA-induced differentiation as well as the association of the EpoR with Vav, STAT5 and the 60 Kd protein. This is of interest since Na3VO4, at the concentrations used here, has been shown to be a potent inhibitor of the activity of protein tyrosine phosphatases. These results suggest that levamisole, at least indirectly, acts by a molecular mechanism similar to that of Na3VO4 and that the loss of the association of the EpoR with Vav, STAT5, and and/or the reduction in the level of tyrosine phosphorylation of these proteins may play a role in MEL cell differentiation
— id: 73228, year: 1998, vol: 12, page: 1307, stat: Journal Article,