CHGA and gangliocytoma: Both the components of the neoplasm strongly and diffusely express neuroendocrine IHC markers like synaptophysim and chromogranin A. A recently reported case by Obiedat et al. described a mixed gangliocytoma-pituitary adenoma of dual lineage, emphasizing the importance of comprehensive immunohistochemical profiling, including transcription factor expression, to fully characterize such tumors.11 In a comprehensive systematic review by Balasubramanian et al., frequently positive IHC stains were growth hormone (GH) (78%), prolactin (59%), followed by synaptophysin (38%).