Introduction: Diagnostic evaluation of Intra-abdominal masses has always remained an enigma in surgical practice. Fine needle aspiration cytology (FNAC) is an alternative for exploratory laprotomy to provide documentary evidence of the nature of pathology before institution of therapy and also prognosis. The objective of the study was to assess the diagnostic accuracy of FNAC in evaluation of Intra-abdominal mass lesions. Methods: Study included 128 intra-abdominal mass lesions detected clinically and radiologically which was further classified into palpable and non palpable masses. Image guided FNAC was performed in non palpable lesions. Smears were made with routine stains and special stains were done wherever required. Histopathological correlation was done wherever possible. Results:The mean age was 45.17 years, with Male: Female ratio of 1:1.3. The diagnostic yield was 95.2% under direct aspiration and 91.8% under Ultrasonography (USG) guidance. There were 74(57.8%) malignant, 30(23.4%) benign, 14(10.9%) inflammatory, 1(0.78%) suspicious lesions and 9(7.03%) unsatisfactory smears. The liver and the ovary were the most common sites. Adenocarcinoma and hepatocellular carcinoma were the most common malignant lesions. This study showed 97.3% sensitivity, 100% specificity, 100% positive predictive value, 93.3% negative predictive value and 98.07% diagnostic accuracy. Conclusion: FNAC is a highly sensitive, reliable, accurate method for rapid provisional pre-operative evaluation of intra-abdominal mass lesions. This has a major impact on the management of patients, avert diagnostic surgical procedures and accelerate the planning for therapy.

Keywords: Guided FNAC; Abdomen; Histopathology; Diagnostic Accuracy.