Diagnosis of umbilical metastasis (Sister Mary Joseph's nodule) by fine-needle aspiration: an immunocytochemical study.

Abstract

During a ten year period, since we introduced needle aspiration cytology at our institution, we have diagnosed five cases of umbilical metastasis (Sister Mary Joseph's nodule). In none of the cases was any false negative or false positive diagnosis rendered and the primary carcinoma was found below the diaphragm. In all the five cases, cell blocks of the aspirate were subsequently prepared, and highlighted the histologic features of the tumour which corresponded with the cytologic diagnosis. Immunohistochemical staining on the aspirate material in all the cases was considered quite useful in substantiating the cytohistologic diagnosis. Based on our findings, we suggest that fine-needle aspiration cytology as an initial diagnostic procedure in cases suspected of umbilical metastasis should be considered, since it is not only a simple, fast, accurate, and inexpensive diagnostic procedure, but can also save the patient from an invasive surgical procedure, the benefit of which is questionable.