Introduction Fine Needle Aspiration (FNA) is an important diagnostic tool in any enlarged lymph node and has significant utility in diagnosing Hodgkin Lymphoma (HL). To evaluate the diagnostic challenges in the cytodiagnosis of Hodgkins Lymphoma and to identify the ways to minimize the false negative diagnosis.

Materials and Methods: A prospective study on 30 FNAC with biopsy proven cases of Hodgkins Lymphoma along with a review of the preoperative FNAC smears and the diagnostic difficulties analyzed.

Results: Fourteen of the 30 cases were labelled HL, which was diagnosed on the basis of atypical mononuclear cells in preference to classic Reed–Sternberg (RS) cells.

Nine cases were termed lymphoproliferative, which showed the presence of only atypical mononuclear cells with eosinophilic nucleoli.

Three cases had an exuberant granulomatous reaction with scattered large mononuclear and occasional classical RS cells in a background of plenty of eosinophils. One case had plenty of histiocytic reaction and scattered single large cells and was called histiocytic reaction in the lymph node and the biopsy proved to be HL.

Fine needle aspiration cytology can be effectively used in the early diagnosis of Hodgkins Lymphoma when corroborated with the clinical details and the nature of the aspirate.