fig2

From: Clinical implications of the molecular characterization of intraductal papillary mucinous neoplasms of the pancreas

Figure 2. Schematic of clonal expansion of IPMN to invasive PDAC. Adapted from Fischer et al.^[25] Intraductal Papillary Mucinous Neoplasms Arise from Multiple Independent Clones, Each with Distinct Mutations, Gastroenterology 2019. This schematic illustrates multiple precancerous cells undergoing clonal expansion with in an IPMN. Clones with distinct mutations in known driver genes (KRAS & GNAS), may acquire further mutations and vie for dominance while displaying increasing levels of dysplasia. Eventually enough key mutations accumulate, and a single clonal becomes dominate and displays invasive behavior.