Skip to main content

Orbit and Ocular Adnexa

  • Chapter
  • First Online:
Atlas of Fine Needle Aspiration Cytology

Abstract

The orbital area contains a variety of anatomical structures including the eyelids, tarsal conjunctiva, caruncle, lacrimal gland, lacrimal drainage system, skin, skin adnexa, and soft tissues. It is surrounded by bone and cartilaginous structures and is highly vascularized and interspersed by the cranial nerves. This complex of neighboring, highly specialized tissues results in a large spectrum of inflammatory, benign, and malignant conditions. An extensive blood supply of the richly vascularized orbital area explains the occurrence of metastases from various organs, commonly from breast and lung neoplasms in adults and neuroblastoma in children. Fine-needle aspiration (FNA), by its simplicity and accuracy, can serve as an important diagnostic tool, solving some of the various clinical dilemmas in this complex anatomic area.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 279.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 379.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Rastogi A, Jain S. Fine needle aspiration biopsy in orbital lesions. Orbit. 2001;20:11–23.

    Article  Google Scholar 

  2. Agrawal P, Dey P, Lal A. Fine-needle aspiration cytology of orbital and eyelid lesions. Diagn Cytopathol. 2013;41:1000. (Epub ahead of print).

    Article  Google Scholar 

  3. Koss GL, Woyke S, Olszewski W. Cytologic interpretation and histological bases. In: Aspiration biopsy. New York: Igaku-Shoin; 1992. p. 659–77.

    Google Scholar 

  4. Krzystolik Z, Roslawska A, Bedner E. The cytological, immunocytochemical and molecular genetic analysis in diagnosis of the neoplasms of the eye, eye adnexa and orbit. Doc Ophthalmol. 1994;88:155–63.

    Article  CAS  Google Scholar 

  5. Nassar DL, Raab SS, Silverman JF, Kennerdell JS, Sturgis CD. Fine-needle aspiration for the diagnosis of orbital hematolymphoid lesions. Diagn Cytopathol. 2000;23:314–7.

    Article  CAS  Google Scholar 

  6. Tani E, Seregard S, Rupp G, Söderlund V, Skoog L. Fine-needle aspiration cytology and immunocytochemistry of orbital masses. Diagn Cytopathol. 2006;34:1–5.

    Article  Google Scholar 

  7. Klijanienko J, El-Naggar AK, Servois V, Rodriguez J, Desjardins L, Schlienger P, et al. Histologically similar, synchronous or metachronous, lacrimal salivary-type and parotid gland tumors: a series of 11 cases. Head Neck. 1999;21:512–6.

    Article  CAS  Google Scholar 

  8. Helsel JC, Bardales RH, Mukunyadzi P. Fine-needle aspiration biopsy cytology of malignant neoplasms of the sinonasal tract. Cancer. 2003;99:105–12.

    Article  Google Scholar 

  9. Char DH, Miller T, Kroll S. Orbital metastases: diagnosis and course. Br J Ophthalmol. 1997;81:386–90.

    Article  CAS  Google Scholar 

  10. Goldberg RA, Rootman J, Cline RA. Tumors metastatic to the orbit: a changing picture. Surv Ophthalmol. 1990;35:1–24.

    Article  CAS  Google Scholar 

  11. Valenzuela AA, Archibald CW, Fleming B, Ong L, O’Donnell B, Crompton JJ, et al. Orbital metastasis: clinical features, management and outcome. Orbit. 2009;28:153–9.

    Article  Google Scholar 

  12. Kennerdell JS, Slamovits TL, Dekker A, Johnson BL. Orbital fine-needle aspiration biopsy. Am J Ophthalmol. 1985;99:547–51.

    Article  CAS  Google Scholar 

  13. Henderson JW, Farrow GM, Garrity JA. Orbital tumors. New York: Raven; 1994.

    Google Scholar 

  14. Cangiarella JF, et al. Fine needle aspiration cytology of orbital masses. Acta Cytol. 1996;40:1205–11.

    Article  CAS  Google Scholar 

  15. Westman-Naeser S, Naeser P. Tumours of the orbit diagnosed by fine needle biopsy. Acta Ophthalmol. 1978;56:969–76.

    Article  CAS  Google Scholar 

  16. Bessiere E. Aspiration biopsy and tumors of the orbit. Bull Soc Ophtalmol Fr. 1959;4:343–7. [In French]

    CAS  PubMed  Google Scholar 

  17. Zeppa P, Tranfa F, Errico ME, Troncone G, Fulciniti F, Vetrani A, et al. Fine needle aspiration (FNA) biopsy of orbital masses: a critical review of 51 cases. Cytopathology. 1997;8:366–72.

    Article  CAS  Google Scholar 

  18. O’Hara BJ, Ehya H, Shields JA, Augsburger JJ, Shields CL, Eagle RC Jr. Fine needle aspiration biopsy in pediatric ophthalmic tumors and pseudotumors. Acta Cytol. 1993;37:125–30.

    PubMed  Google Scholar 

  19. Solo S, Siddaraju N, Srinivasan R. Use of fine needle cytology in the diagnosis of orbital and eyelid mass lesions. Acta Cytol. 2009;53:41–52.

    Article  Google Scholar 

  20. Calle R, Zajdela A, Haye C, Schlienger P. Primary malignant lymphoid tumors of the orbit, eye and adnexa oculi. Treatment and prognosis based on the site of the tumor and its histological type [article in French]. Bull Cancer. 1971;58:329–49.

    CAS  PubMed  Google Scholar 

  21. Zajdela A, Vielh P, Schlienger P, Haye C. Fine-needle cytology of 292 palpable orbital and eyelid tumors. Am J Clin Pathol. 1990;93:100–4.

    Article  CAS  Google Scholar 

  22. Wiktorin ACH, Dafgård Kopp EME, Tani E, Söderén B, Allen RC. Fine-needle aspiration biopsy in orbital lesions: a retrospective study of 225 cases. Am J Ophthalmol. 2016;166:37–42.

    Article  Google Scholar 

  23. Glasgow BJ, Layfield LJ. Fine-needle aspiration biopsy of orbital and periorbital masses. Diagn Cytopathol. 1991;7:132–41.

    Article  CAS  Google Scholar 

  24. Das DK, Das J, Bhatt NC, Chachra KL, Natarajan R. Orbital lesions. Diagnosis by fine needle aspiration cytology. Acta Cytol. 1994;38:158–64.

    CAS  PubMed  Google Scholar 

  25. Liu D. Complications of fine needle aspiration biopsy of the orbit. Ophthalmology. 1985;92:1768–71.

    Article  CAS  Google Scholar 

  26. Sturgis CD, Silverman JF, Kennerdell JS, Raab SS. Fine-needle aspiration for the diagnosis of primary epithelial tumors of the lacrimal gland and ocular adnexa. Diagn Cytopathol. 2001;24:86–9.

    Article  CAS  Google Scholar 

  27. Dhaliwal U, Arora VK, Singh N, Bhatia A. Clinical and cytopathologic correlation in chronic inflammations of the orbit and ocular adnexa: a review of 55 cases. Orbit. 2004;23:219–25.

    Article  Google Scholar 

  28. Kuruba SL, Prabhakaran VC, Nagarajappa AH, Biligi DS. Orbital aspergillus infection diagnosed by FNAC. Diagn Cytopathol. 2011;39:523–6.

    Article  Google Scholar 

  29. Char DH, Miller T. Orbital pseudotumor. Fine-needle aspiration biopsy and response to therapy. Ophthalmology. 1993;100:1702–10.

    Article  CAS  Google Scholar 

  30. Majumdar K, Tyagi I, Saran RK, Kumar S, Gondal R. Multicentric extranodal Rosai Dorfman disease—a cytological diagnosis, with histological corroboration. Acta Cytol. 2012;56:214–8.

    Article  Google Scholar 

  31. Kamal S, Kumar S, Goel R, Bodh SA, Kumar R, Bansal S, et al. Rosai-dorfman with bilateral involvement of lacrimal sac as extranodal disease. Orbit. 2012;31:132–3.

    Article  Google Scholar 

  32. Islam MN, Amin MS, Dipi RM, Khan NA. Comparison of computed tomographic and cytopathological findings in the evaluation of adult orbital mass. Mymensingh Med J. 2013;22:75–9.

    CAS  PubMed  Google Scholar 

  33. Gupta N, Kaur J, Rajwanshi A, Nijhawan R, Srinivasan R, Dey P, et al. Spectrum of orbital and ocular adnexal lesions: an analysis of 389 cases diagnosed by fine needle aspiration cytology. Diagn Cytopathol. 2012;40:582–5.

    Article  Google Scholar 

  34. Mehrotra R, Kumar S, Singh K, Tandon MP, Singh M. Fine-needle aspiration biopsy of orbital meningioma. Diagn Cytopathol. 1999;21:402–4.

    Article  CAS  Google Scholar 

  35. Lakhey M, Thakur SK, Mishra A, Rani S. Pleomorphic adenoma of lacrimal gland: diagnosis based on fine needle aspiration cytology. Indian J Pathol Microbiol. 2001;44:333–5.

    CAS  PubMed  Google Scholar 

  36. Kopp ED, Sahlin S, Tani E, Skoog L, Seregard S. Fine-needle aspiration biopsy in lacrimal gland pleomorphic adenoma. Eye. 2010;24:386.

    Article  CAS  Google Scholar 

  37. Dulani S, Diagavane S, Lele S, Gaurkhede H. A bilobed schwannoma in roof of orbit: a rare case report. Case Rep Ophthalmol Med. 2012;2012:139241.

    PubMed  PubMed Central  Google Scholar 

  38. Malberger E, Gdal-On M. Adenoid cystic carcinoma of the orbit diagnosed by means of aspirative cytology. Ophthalmologica. 1985;190:125–7.

    Article  CAS  Google Scholar 

  39. Lelli GJ Jr, Yang GC. Large cell carcinoma of the lacrimal gland diagnosed by fine needle aspiration biopsy. Orbit. 2011;30:291–2.

    Article  Google Scholar 

  40. Klijanienko J, Vielh P, Batsakis JD, et al. Salivary gland tumours, monographs in clinical cytology, vol. 15. Basel: Karger; 2000.

    Book  Google Scholar 

  41. Das DK, Das J, Kumar D, Bhatt NC, Banot K, Natarajan R. Leiomyosarcoma of the orbit: diagnosis of its recurrence by fine-needle aspiration cytology. Diagn Cytopathol. 1992;8:609–13.

    Article  CAS  Google Scholar 

  42. Pitts J, Chang CH, Mavrikakis I, Shaikh A, Rootman J. Hepatocellular carcinoma presenting as orbital bone metastasis. Ophthal Plast Reconstr Surg. 2008;24:477–9.

    Article  Google Scholar 

  43. Heerema A, Sudilovsky D. Mucinous adenocarcinoma of the ovary metastatic to the eye: report of a case with diagnosis by fine needle aspiration biopsy. Acta Cytol. 2001;45:789–93.

    Article  CAS  Google Scholar 

  44. Kopelman JE, Shorr N. A case of prostatic carcinoma metastatic to the orbit diagnosed by fine needle aspiration and immunoperoxidase staining for prostatic specific antigen. Ophthalmic Surg. 1987;18:599–603.

    CAS  PubMed  Google Scholar 

  45. Khurana AK, Ahluwalia BK, Gupta S, Rajan C, Arora BB. Bilateral proptosis due to metastatic Ewing’s sarcoma of the orbit: fine needle aspiration cytology (FNAC) and histopathology of a case. Indian J Ophthalmol. 1992;40:15–7.

    CAS  PubMed  Google Scholar 

  46. Bernardini F, Bazzan M. Lymphoproliferative disease of the orbit. Curr Opin Opthalmol. 2007;18:398–401.

    Article  Google Scholar 

  47. Subramanian R, Solo S, Mishra MM, Murugan P, Siddaraju N, Basu D, et al. Fine needle aspiration cytology of primary lymphoid lesions of the orbit: report of four cases. Acta Cytol. 2007;51:417–20.

    Article  Google Scholar 

  48. Wolska-Szmidt E, Jakubowska A, Krzystolik K, Chosia M. Fine needle aspiration biopsy and molecular analysis in differential diagnosis of lymphoproliferative diseases of the orbit and eye adnexa. Pol J Pathol. 2004;55:51–7.

    PubMed  Google Scholar 

  49. Chosia M, Wolska-Szmidt E. Is it possible to diagnose lymphoproliferative lesions by fine needle aspiration biopsy? [Article in Polish]. Klin Ocz. 2005;107:555–9.

    Google Scholar 

  50. Shields JA, Shields CL, Ehya H, Eagle RC Jr, De Potter P. Fine-needle aspiration biopsy of suspected intraocular tumors. The 1992 Urwick lecture. Ophthalmology. 1993;100:1677–84.

    Article  CAS  Google Scholar 

  51. Bagchi K, Giri A, Sarkar R, Das S, Nag S. Fine needle aspiration biopsy in the diagnosis of intraocular and extra-ocular mass lesions. J Indian Med Assoc. 2010;108:457–9.

    PubMed  Google Scholar 

  52. Eide N, Walaas L. Fine-needle aspiration biopsy and other biopsies in suspected intraocular malignant disease: a review. Acta Ophthalmol. 2009;87:588–601.

    Article  Google Scholar 

  53. Longmuir SQ, Syed NA, Boldt HC. Diffuse anterior retinoblastoma without retinal involvement. Ophthalmology. 2010;117:2034–8.

    Article  Google Scholar 

  54. Das DK, Das J, Chachra KL, Natarajan R. Diagnosis of retinoblastoma by fine-needle aspiration and aqueous cytology. Diagn Cytopathol. 1989;5:203–6.

    Article  CAS  Google Scholar 

  55. Gündüz K, Müftüoglu O, Günalp I, Unal E, Taçyildiz N. Metastatic retinoblastoma clinical features, treatment, and prognosis. Ophthalmology. 2006;113:1558–66.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jerzy Klijanienko .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Klijanienko, J., Bartuma, K., Domanski, H.A. (2019). Orbit and Ocular Adnexa. In: Domanski, H. (eds) Atlas of Fine Needle Aspiration Cytology. Springer, Cham. https://doi.org/10.1007/978-3-319-76980-6_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-76980-6_18

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-76979-0

  • Online ISBN: 978-3-319-76980-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics