Background:Abdominal masses always are mystery in clinical practice. Improvements have taken place in fine needle aspiration cytology with technical advances in imaging methods of ultrasound and CT.

Aims:To study the utility of guided FNAC in the diagnosis of abdominal lesions and categories the abdominal lesions. To study cytological features of abdominal lesions and correlate with histopathological features wherever possible.

Materials and methods: The study included 82 abdominal lesions. History, clinical features, radiological investigations were obtained in each case. USG or CT guidance was used and the FNA procedure was done. Smears were stained with Giemsa and viewed under the microscope for diagnosis. Diagnostic yield was 95%. Extra material obtained was given for cell block.

Results: The age was from 14 years old to 82 years and majority of them were in the age group of 40 – 60 years. Male to female ratio is 1:1.1. Among 82 cases, 45 cases (54.87%) were malignant, followed by 17 cases (20.74%) benign, 14 cases (17.08%) inflammatory, 04 cases (4.87%) suspicious of malignancy and 02 cases (2.44%) unsatisfactory for evaluation. Majority of the cases are in liver and hepatocellular carcinoma was the most common malignant lesion. In 60 cases histopathological correlation was available and for these cases the diagnostic accuracy is 95%, sensitivity is 92.1%, specificity is 100% and p value is <0.001 which is highly significant.

Conclusion:Abdominal fine needle aspiration cytology is simple, cost effective, rapid and repeatable procedure which helps in categorizing the abdominal lesions.