Pathology Handbook

Chromogranin A and B

Clinical Indications

Chromogranin A is produced by a variety of normal and malignant neuroendocrine and sympathetic neuronal cells and may serve as a clinically useful marker for hormone-negative endocrine neoplasia.

Elevated levels of Chromogranin A are seen in neuroendocrine tumours, including phaeochromocytoma, medullary carcinoma of thyroid, pancreatic islet cell adenoma, carcinoid tumour, anterior pituitary adenoma, carotid body tumour, small cell carcinoma of the lung and neuroblastoma. 

Minor increases are seen in essential hypertension. Chromogranin A concentrations rise markedly in patients with renal failure.

Please note that spuriously high levels of Chromogranin A have been reported in  patients taking proton pump inhibitors

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Analysed by referral laboratory if specific criteria met.

Specific Criteria

Investigation of suspected neuroendocrine tumour, if specifically requested by a Consultant. 

Turnaround Time

3 weeks


EDTA (lemon top)


6 ml


Vacutainer lemon top

Lab Handling

Sent to referral laboratory (Hammersmith Hospital)

Causes for Rejection

Unlabelled or incorrectly labelled sample; not meeting specific criteria for analysis; incorrectly collected sample.

Reference Range

Chromogranin A <60 pmol/L

Chromogranin B <150 pmol/L