Large-duct pattern invasive adenocarcinoma of the pancreas–a variant mimicking pancreatic cystic neoplasms: A minireview

Pancreatic cancer currently has no subtypes that inform clinical decisions;hence,there exists an opportunity to rearrange the morphological and molecular taxonomy that guides a better understanding of tumor characteristics.Nonetheless,accumulating studies to date have revealed the large-duct type variant,a unique subtype of pancreatic ductal adenocarcinoma(PDA)with cystic features.This subtype often radiographically mimics intraductal papillary mucinous neoplasms(IPMNs)and involves multiple small cysts occasionally associated with solid masses.The“bunch-of-grapes”sign,an imaging characteristic of IPMNs,is absent in large-duct PDA.Large-duct PDA defines the mucin profile,and genetic alterations are useful in distinguishing large-duct PDA from IPMNs.Histologically,neoplastic ducts measure over 0.5 mm,forming large ductal elements.Similar to classic PDAs,this subtype is frequently accompanied by perineural invasion and abundant desmoplastic reactions,and KRAS mutations in codon 12 are nearly ubiquitous.Despite such morphological similarities with IPMNs,the prognosis of large-duct PDA is equivalent to that of classic PDA.Differential diagnosis is therefore essential.

A bibliometric study on pancreatic cystic disease research

Pancreatic cystic disease is being increasingly identified in patients,and many relevant papers have been published in this field.A bibliometric analysis was previously performed to identify the most influential studies in many subject areas,and the top 100 most cited papers on pancreatic cystic disease were analyzed in this study.The Web of Science database was searched for all papers related to pancreatic cystic disease on June 9,2018.The top 100 most cited papers were selected and listed in descending order based on the total number of citations(TCs).The author,journal,institution,country of origin,and research focus were further analyzed.The most cited papers were published between 1975 and 2015.Intraductal papillary mucinous neoplasm was the most commonly studied subtype(36%),followed by pancreatic pseudocyst(16%),solid pseudopapillary neoplasm(9%),and mucinous cystic neoplasm(7%).The average number of TCs was 282,and the average citation index value was 21.Thirty-eight journals published the top 100 papers;Annals of Surgery(n=14)and Gastrointestinal Endoscopy(n=11)published the most papers.Most papers were published in the United States of America(59%),with the majority from Johns Hopkins Medical Institution(15%).Canto MI from Johns Hopkins Medical Institution authored the largest number of most cited papers(n=8).This study reviews the significant achievements and developmental trends in pancreatic cystic disease.Abbreviations:CI=citation index,IPMN=intraductal papillary mucinous neoplasm,MCN=mucinous cystic neoplasm,PP=pancreatic pseudocyst,SCN=serous cystic neoplasm,SPN=solid pseudopapillary neoplasm,TC=total number of citation.