Pathology reports: Frequently asked questions

In this section, our team of pathologists answers some of the most common questions about pathology and pathology reports. Have a question? Contact us.

What is a pathology report?

A pathology report is a medical document that describes what was found when a pathologist examined a tissue sample. A pathologist is a doctor who specializes in diagnosing diseases by studying tissues and cells. They work closely with the other doctors on your healthcare team.

Is a pathologist a medical doctor?

Yes. A pathologist is a medical doctor who has extra training in pathology. There are different kinds of pathologists, including those who study tissues (anatomical pathologists), blood and bone marrow (hematopathologists), the brain and nerves (neuropathologists), and those who work on cases related to legal investigations (forensic pathologists). To become a pathologist, a person has to go to medical school, complete residency training, and often do 1 to 2 more years of specialized training called a fellowship.

Can I get a copy of my pathology report?

Yes, you can. Most hospitals now allow patients to access their pathology reports through an online portal. If the hospital or lab that prepared your report does not have an online portal, you can request a copy from the hospital, lab, or doctor.

Are there different types of pathology reports?

Yes, there are several types of pathology reports. The kind of report depends on the tissue type and how it was removed. Some common types of pathology reports include:

• Surgical pathology report: Used for most tissues, including small biopsies, larger pieces of tissue such as excisions, and whole organ resections.
• Hematopathology report: Describes blood, bone marrow, and lymph node samples.
• Neuropathology report: Describes tissue from the brain, spinal cord, and sometimes muscles.
• Cytopathology report: Describes very small tissue samples taken by fine needle aspiration, pap smears, bronchoalveolar lavage, or urine.
• Autopsy or forensic pathology report: Used when a body is examined after a person has died.

What information is included in a pathology report?

Pathology reports have sections for patient information, specimen source (where the tissue came from), medical history, and diagnosis. Reports for tissue samples, like biopsies or resections, also include a section that describes what the pathologist saw under the microscope. If a tumour is found, there will be information about the type, size, and whether it has spread. Some reports will also mention if the tissue was examined during surgery.

How long does it take to get a pathology result?

Getting a pathology result can take anywhere from 1 day to several weeks. It depends on the type of tissue, how big the sample is, and if any extra tests are needed. Before the tissue can be examined, it needs to be put on glass slides and stained so that it can be seen under a microscope. For small samples, like those from a fine needle biopsy, this usually takes 1 to 2 days. For larger tissues, it takes longer because the pathologist needs to choose the best areas to look at under the microscope, which can take an extra 3 to 4 days. The pathologist can usually complete the examination in 1 day, but if additional tests are needed, it can take another 1 to 5 days.

Can a pathology report be wrong?

Although it is rare, a pathology report can be wrong, just like any other medical test. Studies show that the error rate in pathology is very low (less than 2%), so most reports are correct.

What does it mean if a pathology report says the tissue “may not be representative”?

This means that the tissue sample examined may not fully show the changes or abnormalities present in the whole area. Sometimes, only a small piece of tissue is taken during a biopsy, so it might miss important features. Your doctor might recommend another biopsy or test to get more information.

What does it mean if the pathology report says “suspicious”?

When a pathology report says “suspicious,” it means that there are changes in the tissue that could be related to a disease, such as cancer, but it is not completely clear. More tests or a follow-up biopsy may be needed to make a definite diagnosis.

What does it mean when a pathology report says “cannot rule out”?

“Cannot rule out” means that the pathologist cannot completely exclude a possible diagnosis based on the tissue sample. There may be signs that suggest a condition, but more information is needed to be certain. This often means that further tests, a different biopsy, or more tissue is needed for a final answer.

What does it mean if a pathology report says “at least” in the diagnosis?

When a pathology report says “at least,” it means the pathologist found a certain level of disease or abnormality, but there might be more that they can’t see in the sample. For example, if the report says “at least high grade dysplasia,” it means that the pathologist can see abnormal cells, but there might be invasion (cancer spreading into deeper tissues) that wasn’t included in the sample. This wording is used to give your doctor an idea of what the pathologist observed, even though the full extent of the condition might not be clear from the current sample.

How do I get a second opinion?

If you want a second opinion, you can ask your doctor to send your pathology report and tissue samples to another pathologist. Your doctor can help with this process and may suggest a specialist in the area of concern. A second opinion is common and can give you more information about your diagnosis.