Considering the fact that the majority of neuroendocrine tumors arise from the tubular GI tract, pancreas, and lung, we proposed a diagnostic algorithm using a panel of IHC stains including NKX2.2, PDX-1, CDX-2, and TTF-1 would aid the diagnosis of the primary tumor site in the setting of metastasis (Fig. 4). Here, PDX1 is linked to neoplasm.