Endoscopic ultrasound (EUS) has become an indispensable tool for the diagnosis and staging for gastrointestinal and thoracic malignancies. Thanks to the safety and reliability of fine needle aspiration (FNA), this has become the method of choice for tissue acquisition from lymph nodes and tumors in various locations within the thoracic and abdominal cavities.
In the recent years, EUS-FNA has offered a better understanding of the pathophysiology of cancer. Similar to the adenoma-carcinoma sequence, other cancers including pancreas, lung, and esophagus may follow a comparable multi-step process of carcinogenesis. A necessary component of these is the ability to go ”beyond cytology” to use fine needle aspirates to characterize the genomic and proteomic profiles of cancer and precancerous tissue.
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