<b>Characterization of adrenal lesions through fine needle aspiration cytology</b>:<b>A descriptive cross-sectional study at a tertiary hospital</b>

<b>Background:</b> Fine needle aspiration cytology (FNAC) has revolutionized the diagnosis of adrenal lesions following the advent of CT imaging. Adrenal masses, often detected incidentally during imaging for other conditions, present a spectrum ranging from benign adenomas to metastatic malignancies.<b>Methodology:</b> This descriptive observational cross-sectional study spanned nine years at a tertiary care hospital in South India, involving 19 cases of adrenal lesions subjected to image-guided FNAC. Demographic data, clinical presentations, radiological findings, and cytological features were analysed. Histomorphology correlation was available for a subset of cases.<b>Results:</b> Among the 19 cases analysed, FNAC identified 17 neoplastic (2 benign and 15 malignant) and 2 non-neoplastic lesions. Histomorphological correlation confirmed FNAC diagnoses in 14 cases, achieving a specificity of 100%.Various entities were identified, including adrenal adenomas, metastases (lung, breast, renal cell carcinoma), neuroblastomas, and ganglioneuroblastomas. Challenges included inadequate sampling in 5.3% of cases.<b>Conclusion:</b> FNAC emerges as a valuable tool for diagnosing adrenal lesions, guiding management decisions, and avoiding unnecessary surgeries. Collaboration between radiologists and cytopathologists is crucial for achieving accurate diagnoses and optimizing patient care.