Hematologist
CION Cancer Clinics
Getting your slides released for a second opinion | CION Cancer Clinics
You can usually get your slides and tissue blocks released for a second opinion by asking the laboratory in writing, with a request letter from the reviewing haematologist, the patient's ID and signed consent. Name each item you need: stained slides, the block, special stains and flow cytometry data. This page explains the steps, the words on the form, and what a review cannot tell you. At CION Cancer Clinics, our haematologist reviews abnormal blood reports with you, orders only the tests that answer your question and explains each result plainly.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- Can you get your slides released for a second opinion?
- What exactly can the laboratory send?
- How do you ask for your slides to be released?
- What do the words on the release form mean?
- What do families get wrong about slide release?
- What should you check when you collect the material?
- What if the laboratory delays or refuses?
- Common questions about releasing slides
The short answer
Can you get your slides released for a second opinion?
Yes, in most cases. The glass slides and tissue blocks from your blood or bone marrow test belong to your care, and the laboratory that holds them will usually release them when you ask in writing. The laboratory keeps a record of what went out, and often keeps some material back.
Why the slides matter more than the report
A report is one doctor's reading of what they saw under the microscope. A second opinion on a blood cancer is only as good as what the second doctor can look at. If they only see the printed report, they can comment on the wording. If they see the slides, the block and the flow cytometry data, they can form their own view of the diagnosis itself.
Asking is not an accusation
Many families worry that asking for slides will offend the first hospital. It should not. Pathologists and haematologists send material for review all the time, and a request for a second opinion is a normal part of care for a serious diagnosis like leukaemia or lymphoma.
Who this is not for
If the first doctor is already sending your slides to a reference laboratory for a specialist review, you may not need to ask separately. Ask them where the material has gone before you start a second request.
This page explains the usual process. Each laboratory sets its own forms, fees and timelines, so check with the one that holds your material.Know what to ask for
What exactly can the laboratory send?
Asking for "the slides" is often not enough. Name each kind of material, because a reviewing haematologist may need more than one.
Stained glass slides
The thin sections or smears the first pathologist actually read. These include the routine stained slides and any special stains done for your case.
Often includes
- Blood smear and marrow aspirate smears
- Marrow biopsy (trephine) sections
- Lymph node sections
The paraffin block
The tissue itself, set in wax. With the block, the second laboratory can cut fresh sections and run its own extra stains. Some laboratories send a block only with a signed undertaking to return it.
Unstained sections
Fresh thin cuts from the block, left unstained on glass. Laboratories offer these when they need to keep the block, for example when very little tissue is left.
Ask how many were cut. Too few can limit what the second laboratory can test.Test data and reports
Flow cytometry plots, genetic test reports and the full pathology report with its laboratory number. The raw flow data is often what lets a specialist check a difficult leukaemia or lymphoma result.
Not sure whether this applies to you?
Ask an oncologistThe process
How do you ask for your slides to be released?
Get a request letter
Ask the haematologist giving the second opinion for a short letter naming the material they need. Laboratories act faster on a doctor's request, and the letter tells them exactly what to pull out.
Apply in writing
Take the letter to the laboratory or hospital records desk with the patient's ID, the original report and a signed consent. If a family member is applying, carry a signed authorisation from the patient.
Pay and get a receipt
Many laboratories charge a retrieval or handling fee. Ask for a written receipt that lists each slide and block by its laboratory number, so nothing is missed later.
Collect and carry safely
Carry slides flat in the box they give you, away from heat and moisture. If sending by courier, use a tracked service and pack them so the glass cannot move.
On the forms
What do the words on the release form mean?
- Laboratory or accession number
- The unique number the laboratory gave your sample. Quote it on every request. It is printed on the original report.
- Trephine
- The small core of bone marrow taken with a needle. It becomes a block and a set of slides.
- Recuts
- New thin sections cut from the existing block. They let another laboratory run its own stains without a fresh biopsy.
- Immunohistochemistry (IHC)
- Special stains that show which markers the cells carry. These slides are often the most useful ones to send.
- Chain of custody
- The written trail showing who handled the material and when. It protects you if a slide goes missing.
- Undertaking to return
- A signed promise that the block will come back to the first laboratory after review.
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
Commonly believed
What do families get wrong about slide release?
"The hospital owns the slides, so we cannot take them."
The laboratory is responsible for storing them, but the material exists for your care. Laboratories routinely release slides and blocks for a second opinion when the request is in writing and properly authorised.
"The report is enough. The second doctor can just read it."
A report tells the second doctor what the first doctor concluded. It does not let them check it. For a blood cancer, the second view is far more useful when the reviewer can see the slides and the flow data themselves.
"We will just repeat the bone marrow test somewhere else."
Sometimes a repeat is needed, but it is another procedure, and treatment may have changed the marrow since. Reviewing the original slides first is often quicker and shows what the marrow looked like at diagnosis.
"Asking for a second opinion will delay treatment."
It can add some time, which is why the request should go out early. For an aggressive leukaemia, your doctor may start treatment while the review runs. Ask them directly whether waiting is safe in your case.
Before you leave the desk
What should you check when you collect the material?
Check this
Why it matters
Every slide carries the same laboratory number as the report
Mislabelled material makes the review worthless
Special stain slides are in the box, not only routine ones
The reviewer needs them to confirm the cell type
No slide is cracked or chipped
Damaged glass may not be readable
You have a signed list of what was handed over
It settles any later question about missing items
You know when the block must be returned
The first laboratory may need it again
Being straight with you
What if the laboratory delays or refuses?
Most delays come from missing paperwork, not unwillingness. Ask the desk exactly what is missing and get it in writing. A phone call from the reviewing haematologist to the first pathologist often clears things faster than repeated visits.
When material cannot be sent
Sometimes very little tissue is left, and the laboratory must keep the block for legal or clinical reasons. Ask for recuts or unstained sections instead, or ask whether the second laboratory can send its pathologist's questions to the first one directly.
What a slide review cannot tell you
A second opinion checks the diagnosis on the material that exists. If the original sample was small, clotted or diluted with blood, no reviewer can add what is not on the glass. In that case a repeat test may be the honest answer. A review also does not tell you how treatment will go. Only your haematologist can talk you through that, with the full picture.
How CION helps
CION's haematology team reviews the case, tells you which material to request and presents it to a tumour board. We coordinate with the laboratories and qualified centres involved rather than asking you to manage every call alone.
Questions we are asked
Common questions about releasing slides
Can a family member collect the slides for the patient?
Usually yes, with a signed authorisation from the patient, a copy of the patient's ID and the collector's own ID. If the patient is a child, a parent signs. If the patient is too unwell to sign, ask the laboratory what they accept, as rules vary between hospitals.
Will the first hospital know I am getting a second opinion?
Yes, because the request goes through them. That is normal and nothing to feel awkward about. Many haematologists welcome a second review on a difficult blood cancer, and some will send the material themselves if you tell them where it is going.
Is there a fee for releasing slides and blocks?
Many laboratories charge a retrieval or handling fee, and cutting fresh sections may cost extra. The second laboratory will also charge for its review and any new stains. Ask both for a written estimate before you start, and check what your insurance or scheme covers.
Can I send the slides by courier from my district?
Yes, if they are packed well. Use the slide box the laboratory gives you, wrap it so the glass cannot move, and choose a tracked service. Keep the receipt and the list of items. Tell the receiving laboratory to expect the parcel so it is logged on arrival.
What if my slides are old?
Stained slides and wax blocks keep well when stored properly, so older material can often still be reviewed. Some stains fade over time. The reviewing laboratory may cut fresh sections from the block if the old slides are hard to read. Ask the first laboratory how long it keeps material.
Does the review replace a repeat bone marrow test?
Sometimes. If the original sample was good, a review of the slides may settle the question without another procedure. If the sample was poor, or treatment has already started, a repeat test may still be needed. Your haematologist decides after looking at what was sent.
Should treatment wait for the second opinion?
Not always. Some blood cancers need treatment quickly, and waiting could do harm. Do not stop or delay any treatment on your own. Ask your treating haematologist whether it is safe to wait, and ask the second team how soon they can give their view.
Will I get the block back after the review?
It depends on what you signed. Blocks are often returned to the first laboratory, which stays responsible for storing them. Slides may stay with the reviewing laboratory. Ask both sides where the material will be kept, so you can find it again if a later test is needed.
Your Haematologist
Meet CION's haematologist. One specialist for your blood report and your plan.
Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Sources
- National Cancer Institute — Pathology Reports
- Cancer.Net — Seeking a Second Opinion
- American Cancer Society — Understanding Your Pathology Report
- NICE — Haematological cancers: improving outcomes (NG47)
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
When Two Haematology Reports DisagreeWhat to do when the second view differs from the firstWhere Marrow Slides and Blocks Are StoredFind out who holds your material and for how longRepeat Testing vs Re-Reviewing Existing SlidesWhether you need a new test or a review of the old oneHaematology Lab and Pathology QualityThe full guide to lab quality in blood cancer diagnosis
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Tell us what has been found so far. CION's haematology team will tell you which slides and reports to request and help you reach the right specialist.