Mediastinal masses encompass a wide variety of lesions ranging from benign cysts to granulomatous inflammation to metastatic carcinomas, lymphomas, thymomas, germ cell tumors, neurogenic tumors, to name a few [1]. Timely evaluation is the first step towards efficient management. With the advancement of imaging modalities, traditional open biopsies and wide excisions have been replaced by minimally invasive techniques like imaging guided and Endoscopic Ultrasound (EUS) guided Fine Needle Aspiration Cytology (FNAC) and core needle biopsies (CNB) to diagnose mediastinal lesions. FNAC is a rapid, time saving and well tolerated investigation which can be performed as an out - patient procedure with minimum hospitalization and rare post procedural complications. However, on occasions, restraints in sample adequacy forbid a specific cytological diagnosis. Subsequently repeat FNAC or CNB or open biopsy is not only inconvenient and costly, but may also delay the diagnosis and further treatment [2]. In many clinical scenarios, clinicians only opt for FNAC and no biopsy is done. Very few studies have compared cytology with histopathology of mediastinal masses.

In this study, we have compared cytological and histopathological diagnosis of cases who underwent FNAC as well as core needle biopsy of mediastinal masses. Reasons of cyto – histopathological discordance have been discussed so that diagnostic pitfalls of cytology can be minimized and the clinician can optimize the management and treatment of patients presenting with mediastinal masses.