Ultra sound due to its safety, low cost and ease of performance is the primary method of choice in liver imaging. In addition, at present time, real time sonography appears to be one of the most accurate guided technique for liver biopsy. This study was undertaken to evaluate the value of sonographically guided fine needle aspiration cytology ( FNAC) in diagnosis of focal hepatic lesions in 80 cases.

          All of the patients were scanned by an ultrasound machine (Aloka – 620) with 3.5 MHz probe. The best location and the most available lesions were selected and F.N.A was performed by 21^G Spinal needle.

          The results of aspiration cytology were compared with finial diagnosis achieved by tissue biopsy, surgery or other imaging modalities such as CT scan. Final diagnosis of malignancy was established in 63 cases, corresponding with the results of aspiration cytology in 53 cases. Most of false negative cases (6 from 10) was due to small size ( under 20^mm ) and deep location of lesions (above 6^cmdeep), causing technical problems in performing F.N.A. According to the findings, sensitivity, specificity & accuracy
   of F.N.A.C for malignant lesions of liver were 92%, 90% and 91.5% respectively.
          On the basis of results, this procedure can be very effective, low cost and low risk in diagnosis of malignant hepatic lesions.