Introduction: Benign and malignant hepatic lesions need timely and accurate diagnosis for proper management. Fine needle aspiration cytology (FNAC) under ultrasonograhy guidance is primary investigation for liver lesion specially in deep seated lesions as it is minimally invasive, precise and reproducible investigation.

Material and methods: A total of 95 cases suspected for liver lesions were subjected to FNAC over a period of one year. Coagulation parameters along with complete blood counts were done on all the patients. The cytological aspirates were obtained using a 22 gauze spinal needle under ultrasound evaluation. Air dried and wet fixed (95% alcohol) smears were prepared for May-Grunwald Giemsa and Papanicolaou or Hematoxylin and Eosin stain respectively. Special stains were used wherever necessary. Diagnosis was made on the basis of cytomorphological features of the lesion.

Results: Patients age ranged from 15-90 years with maximum number of patients were in sixth decade. There was male predominance. The cytological diagnosis was made 79% cases. Cytomorphologically liver lesions were categorized in to malignant (58.95%), benign (11.58%), and non-conclusive (21.05%). Benign lesions included cirrhosis liver (5), fatty liver (4), and pyogenic liver abcess (2). Out of 56 malignant cases, 51 (91.07%) were of metastatic deposits including adenocarcinoma, renal cell carcinoma, mesenchymal tumor, mucinous and sqamous cell carcinoma. 5 cases (8.93%) were of primary origin which all are hepatocellular carcinoma (HCC). Primary site for liver metastasis was diagnosed in 33 cases (64.7%) and unknown in 18 cases (35.3%). Primary origin from various sites included from gall bladder (n=10), gastrointestinal tumor (n=6), pancreas (n=6), breast (n=5), bronchogenic (n=3), renal cell carcinoma (n=2) and mesenchymal (n=1).

Conclusion: Along with other supportive investigation finding, FNAC have important role in the diagnosis and management of various hepatic lesion in early stage.