Introduction: Computed tomography guided fine needle aspiration cytology is a safe and well established technique for the diagnosis of lung and mediastinal lesions. This study was carried out in the department of pathology in the tertiary health care and teaching institute where radiology department is well established. The aim was to study the cytomorphology of the spectrum of the lung and mediastinal lesions and to correlate the cytological diagnosis with the radiological diagnosis. Material and methods: Computed tomography guided fine needle aspiration cytology was done in 90 pateints after taking written consent of the patient. Patients were explained the benefits and risks of the procedure. The results were analysed. Results: A total of 90 patients were included in the study. There were 81 patients of lung lesions and nine patients of mediastinal lesions. There were 63(70%) males and 27(30%) females. Adequate aspirate was obtained in 77 patients giving the adequacy rate of 85.55%. Adenocarcinoma was the most common type of lung malignancy and Non Hodgkins Lymphoma was the most common malignancy in the mediastinum. Inflammatory lesions were seen in 13 cases. Granulomatous lesions were found in six patients. One interesting case of hydatid with aspergillosis was diagnosed on cytology smears, which on radiology was diagnosed as neoplastic. Pneumothorax was seen in three patients. No patient required chest tube insertion. Conclusion: Computed tomography guided fine needle aspiration cytology is a safe and reliable method for the diagnosis of lung and mediastinal lesions. It can help in early diagnosis and initiation of the treatment avoiding major surgical procedures.

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