Mixed neuroendocrine–non-neuroendocrine neoplasms are defined by both components being present in meaningful amounts, conventionally each at least 30%. But a smaller high-grade neuroendocrine component can still matter clinically, and the report is where that information survives.
A short structured statement is enough for the oncologist to act on.
- State whether a neuroendocrine component is present, its grade, and its estimated percentage.
- Confirm neuroendocrine differentiation with at least two markers, such as synaptophysin and INSM1.
- Give a Ki-67 index for the neuroendocrine component separately.
- Note a high-grade neuroendocrine component even when it is below the threshold for a mixed tumour.
- Say which component is present in lymph nodes or other metastatic deposits.
Why it matters
Oncologists may treat by the component that drives spread, and only the report tells them which one that is.
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