Requesting Tissue Blocks and Slides for Second Opinion
Can I get my actual tissue blocks and slides sent to another pathologist for a second opinion?
Yes, contact the original hospital's pathology department (not HIM) and submit a written request specifying where to send the materials. Labs must retain tissue blocks and slides for at least 10 years, and second opinion pathology changes the diagnosis or treatment plan in up to 10% of cancer cases.
Unlike most medical records, pathology has a unique physical component: the tissue itself. Preserved in paraffin wax blocks with glass slides, these are the physical evidence of your diagnosis—and you have the right to have them reviewed by another expert.
Why You Might Need Your Blocks and Slides
The primary reason to request your pathology materials is to obtain a second opinion. While pathology is a rigorous science, there can be interpretive differences between pathologists, especially in rare or complex cases.
Benefits of a Second Opinion:
Your Right to Physical Specimens
Your right to have pathology materials sent for a second opinion is well-established and protected. While the physical blocks and slides are property of the originating institution, you have a right to have them reviewed by a consultant of your choice. The provider cannot deny your request.
| Specimen Type | Typical Retention Period |
|---|---|
| Paraffin Blocks | 10 years or more |
| Glass Slides | 10 years or more |
| Pathology Reports | At least 10 years, often permanently |
Good News: These retention periods mean that even if your diagnosis was several years ago, the physical evidence should still be available for review.
The Process for Requesting Your Materials
- 1.Identify the Second Opinion Institution
Decide where you want materials sent—typically a large academic medical center or cancer center with expertise in your condition. Your oncologist can usually recommend one.
- 2.Contact the Second Opinion Institution
Contact their pathology department. They will provide their address and any required forms for incoming consultations.
- 3.Make the Request to the Original Institution
Contact the HIM or Medical Records department where your biopsy was processed. Submit a formal written request including your name, DOB, procedure date, and the receiving institution's full address.
- 4.Follow Up and Expect Fees
The process typically takes 1-2 weeks. The original lab may charge a fee for retrieval and shipping. Follow up with both institutions to confirm receipt.
How MedicalRecords.com Helps
Facilitate Your Second Opinion
We can manage the entire process, from identifying a subspecialist to coordinating the transfer of your materials.
Request Your Report
Before seeking a second opinion, you'll need your original report. Let us get that for you.
Understand Your Diagnosis
Once you have both reports, we can help you understand the findings and prepare questions.
Want a Second Opinion on Your Pathology?
We can coordinate the transfer of your tissue blocks and slides to a leading expert for review.
Get a Second OpinionFrequently Asked Questions
What is a paraffin tissue block and how long is it kept?
A paraffin tissue block (also called a FFPE block — formalin-fixed, paraffin-embedded) is a small wax cube that preserves your biopsy or surgical tissue for long-term storage. The tissue is fixed in formalin, processed through a series of chemicals, and embedded in paraffin wax, which protects it indefinitely. Pathology labs are required to retain tissue blocks for a minimum of 10 years, and many institutions retain them permanently. These blocks are the definitive physical evidence of your diagnosis and can be re-examined or tested years later.
Is there a fee to transfer my tissue blocks and slides to another hospital?
Yes, most hospitals charge a fee for retrieving, preparing, and shipping your tissue blocks and glass slides to another institution. Fees typically range from $50 to $200 or more depending on the number of blocks and the distance shipped. The receiving institution may also charge a consultation fee for the pathologist's second opinion review. Some insurance plans cover pathology second opinion consultations at major cancer centers, so check your benefits before requesting the transfer.
Can my tissue blocks be used for additional molecular testing later?
Yes, paraffin tissue blocks can be used for additional molecular and genetic testing years after the original diagnosis. This is particularly important as new targeted therapies are developed — tissue banked from your original biopsy can be tested for newer biomarkers to determine if you are eligible for new treatments. However, the amount of tissue in a block is finite, so your oncologist should prioritize and sequence testing appropriately to preserve enough material.
Do I need my doctor's help to request a pathology second opinion, or can I do it myself?
You can initiate a pathology second opinion yourself without going through your physician. Contact the original pathology department and request that your blocks and slides be transferred to the second opinion institution, which you should also contact to coordinate the incoming consultation. However, having your oncologist involved is strongly recommended because they can communicate clinical context to the reviewing pathologist and ensure the second opinion addresses the specific clinical questions that will affect your treatment.