Surgical Pathology Consultations / Second Opinions

The Department of Pathology routinely provides second opinions on diagnostic materials prepared elsewhere. Second opinions may be sought by pathologists, clinicians at other institutions or patients.

The request for second opinions can be addressed to the BWH Pathology Department, or to a specific pathologist on staff. A list of staff pathologists and their respective specialties is available A list of staff pathologists and their respective specialties is available here.

Download our Pathology Consult Request form.

If you are a patient

In most cases, insurance companies will pay for a second opinion; however, it is important to discuss with your insurance provider whether you will have to pay some or all of the cost of the second opinion.

Your physician will need to collect the materials from the primary pathology lab, prepare them for submission, and deliver the sample to our laboratory for examination.

For a patient who is requesting a pathology consult self-pay within the U.S., they will be required to:

• Complete the Pathology Consult Request Form. The entire form must be completed and signed by the patient.
• Provide the name of their primary care doctor or specialist who is treating them along with their address and fax number.
• A copy of the report will be sent to the referring MD (PCP or specialist)
• A copy will also be sent to the originating facility of the slides
• The patient will not receive a copy of the report. They will obtain the results from their physician

If you are a BWH physician

If the patient is being seen by a Brigham and Women's Hospital physician, please include the following:

• Pathology Consult Request Form. Only the top section needs to be completed.
• Glass slides, either stained or unstained. Paraffin blocks, epon-embedded tissues for electron microscopy, electron micrographs, frozen tissues, fixed tissues, and fluids may also be submitted for special studies or if required for accurate diagnosis.
• A copy of the referring pathologist's final report, or at least a preliminary report. If the case has been previously seen by other consultants, copies of those reports should also be included.
• Package must be addressed to "SLIDE COORDINATOR"

If you are a physician at another institution

If you are a physician at an institution other than Brigham and Women's Hospital and you would like a consultative review of pathology performed and diagnosed at your institution, please include the following:

• Pathology Consult Request Form. The entire form must be completed and signed by a physician.
• Glass slides, either stained or unstained. Paraffin blocks, epon-embedded tissues for electron microscopy, electron micrographs, frozen tissues, fixed tissues, and fluids may also be submitted for special studies or if required for accurate diagnosis
• A copy of the referring pathologist's final report, or at least a preliminary report. If the case has been previously seen by other consultants, copies of those reports should also be included.
• A letter from the referring physician or pathologist which identifies the patient by name, give a brief clinical history, identifies the slides and/or blocks by accession number, and identifies of the tissue source for each accession number.
• Additional studies, including laboratory data, radiology studies, etc., should be submitted if essential for accurate diagnosis.

How to send materials

All materials sent by either standard or express mail must be protected from damage by using proper packaging.

• It is recommended that glass slides be enclosed in plastic slide boxes (available in most laboratories) which hold up to five slides each.
• Excess space in the box under the lid should be filled with cotton gauze or tissue paper, to avoid breakage due to shaking.
• The lid of the box should be taped closed.
  Slide boxes should be surrounded by the relevant pathology reports and/or referral letter), enclosed in a rigid mailing container (either a cardboard box or rigid screw-cap mailing tube), and the space around the materials filled with padding (gauze, paper, or Styrofoam).
• It is suggested that all materials related to the case by shipped in the same container, so that they are received together.
• Frozen tissues should be sent by express mail in dry ice.

The envelope, box or cylinder should be tightly closed and sealed with tape. The mailing label should include a return address as well as the name of the referring clinician or pathologist, and addressed to:

[Pathologist name] (if known)
Brigham and Women's Hospital
Department of Pathology
75 Francis Street
Boston, MA 02115

Material sent by express mail or from outside the U.S. usually requires identification of the contents. A sample label might read:

Glass slides of Human Tissue for Diagnosis
Non-Infectious
Non-Hazardous
No Commercial Value

Some carriers, such as DHL, may additionally require identification of the body part, e.g., skin.

For questions for proper shipment of specimens other than those described above, please contact the carrier, our main office (617-732-7510), or the specific specialty division for instructions.

All original materials will be returned to the referring site on completion of our studies. We will retain any additional slides that we have prepared in our laboratories. A copy of our diagnosis will be sent to the referring physician.