Both intraductal papillary-mucinous neoplasm (IPMN) and conventional PC occur from the pancreatic ductal epithelium, but both tumors are thought to
be completely different in terms of size of the originating duct, style of progression, genetic alterations, and prognosis. However, some IPMNs gradually and/or immediately progress to invasive carcinoma with malignant transformation through accumulation of genetic alterations, i.e. some conventional PCs occur via IPMN (fig. 2) . Furthermore, there are some PCs with papillary ICs in the main pancreatic duct and large-branch pancreatic ducts. These ICs without copious mucin production are papillary or low papillary (fig. 2). It is sometimes problematic to diagnose whether conventional PC or an invasive carcinoma derived from IPMN; these PCs can be thought of as intermediary carcinomas between conventional PC and IPMN.
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