Cytology of the orbit and ocular adnexa

The orbit and ocular adnexa, which cytopathologists are rarely requested to investigate, is one of the most complex and difficult anatomical regions to investigate cytologically. Furthermore, the scarcity of routine orbit and ocular adnexa cytology increases the difficulties of cytopathologists who often have to deal with scanty cellular samples from different and sometimes complex or rare pathologies; moreover, the specific clinical and anatomical features require close cooperation between ophthalmologists and cytopathologists. In fact, whereas cytopathologists routinely perform fine needle cytology (FNC) on much of the palpable and impalpable lesions by themselves, in this specific field the insertion of the needle is an almost exclusive task of ophthalmologists. The cytopathologist’s role is that of making smears, evaluating adequacy, managing diagnostic material, selecting ancillary techniques and making the final diagnosis. Finally, orbital and ocular adnexa cytology, as in other regions, has been improved by immunocytochemistry (ICC), flow cytometry (FC) fluorescence in-situ hybridization (FISH) and molecular techniques, however, the usage of these procedures is often impeded by the scanty material obtainable, the management of which further increases the complexity of the cytological approach.