What Does “Pending” or “Additional Testing Required” Mean in my Pathology Report?

by Jason Wasserman MD PhD FRCPC
October 14, 2026

“Pending” means a test result, or part of a pathology report, isn’t finished yet. You might see the word in your patient portal or health record app, where a biopsy or blood test status says pending. You might also see it in a pathology report next to a test still being done, or in a note saying additional testing is required.

This article explains what pending means on a pathology report and in a patient portal, and why a result can still show pending after your doctor has called you. It also explains preliminary and final reports, why doctors order additional testing, and what an addendum, amended report, or corrected report means.

What does “pending” mean on a pathology report or patient portal?

“Pending” can mean slightly different things on a pathology report and in a patient portal. On the report itself, pending usually appears next to a part of the work still in progress. For example, the diagnosis may be written, but a biomarker test or a specialist’s opinion is listed as pending.

In a patient portal, “pending” applies to the entire test or order. It usually means the final report has not been signed and released to your record. Portals also use terms like “in process,” “in progress,” “collected,” “received,” or “preliminary” for tests that aren’t finished. Once a test is complete, the status changes to “final,” “resulted,” or “complete.”

When a test shows “pending,” the status doesn’t tell you the result. It only means the test hasn’t reached its final, signed form in your record.

Why does my portal still say “pending” after my doctor gave me the results?

It is common for a portal to still show “pending” after your doctor has already told you the results. Several situations can cause this.

The pathologist called your doctor first. Pathologists often phone the doctor with an important or urgent result before the written report is finished. The portal will show pending until the pathologist signs the final report.
Part of the report is still in progress. The main diagnosis may be complete while extra stains, biomarker tests, or a second opinion are still being done. Some portals keep the whole report as pending until every part is finished.
Results are released only after review. Some hospitals and clinics hold certain results, such as biopsy reports, until the ordering doctor has reviewed them. Your doctor can see the result, but it hasn’t been released to you yet.
The portal has not updated. Some portals receive results from the laboratory system in batches, so a signed report can take a day or more to appear.
A different test is still pending. One visit can create several orders. Your doctor may have received one result while another test from the same day still shows as pending.

A test that was ordered but never collected, or was canceled, can also stay pending for weeks. If a status hasn’t changed in a long time, ask your clinic to confirm whether the test was actually done.

What is the difference between a preliminary report and a final report?

A preliminary report is an early version of a result shared before testing is finished. A final report is the complete, signed version that becomes part of your permanent medical record.

Preliminary reports are common in microbiology. For example, a blood culture may be reported as “no growth at 48 hours” as a preliminary result, then reported as final after five days. A urine culture may first say that bacteria are growing before the type of bacteria and the antibiotics that work against them are known.

In pathology, your doctor usually receives a preliminary diagnosis by phone rather than a separate report. The final pathology report includes the diagnosis and the results of any additional testing done before it was signed.

Why is additional testing ordered after the first look?

Additional testing, also called further testing, is ordered when the pathologist’s initial review of your sample raises a question they can’t answer by looking alone. The pathologist first examines thin slices of tissue stained with hematoxylin and eosin (H&E). Many diagnoses can be made from these slides alone, but some cases need more information.

Immunohistochemistry. Immunohistochemistry (IHC) uses antibodies to find specific proteins in cells. It helps confirm tumor type or distinguish conditions that look alike under the microscope. It is the most common additional test in pathology.
Special stains. Special stains are dyes that highlight structures hard to see on routine slides, such as bacteria, fungi, mucin, or iron. They are often used to look for infection.
Deeper levels. The pathologist may request additional slices cut from deeper in the tissue block. This is common with small biopsies, where the important area may not be on the first slides.
Biomarker and molecular tests. Tests such as FISH, PCR, and next-generation sequencing (NGS) look for changes in genes or proteins. For many cancers, these results help guide treatment decisions. Some are sent to a specialized outside laboratory.
A second opinion. Another pathologist may review difficult or rare cases, either in the same hospital or at a specialist center. This is a routine part of ensuring an accurate diagnosis.

The Biomarkers and Genetic Testing section explains the biomarker tests most often ordered for each type of cancer.

How much time does additional testing add?

The extra time additional testing adds depends on which tests are pending. Extra stains usually add about one to three working days. An outside second opinion usually adds about three to seven working days. Molecular testing can add one to three weeks or more, especially when the sample is shipped to another laboratory.

Our article How long do pathology and lab test results take? gives typical turnaround times for each test type and explains why some take longer.

Can blood tests and cultures show “pending” too?

Blood tests, antibody tests, and cultures can all show pending in a patient portal, not only pathology reports. The reasons are often different from those for a biopsy.

Tests sent to another laboratory. Many specialized blood and antibody tests are done at only a few laboratories. They stay pending while the sample is shipped and tested, which can take one to two weeks or longer.
Tests run on certain days. Some less common tests run in batches once or twice a week so that a sample may wait several days before testing.
Cultures. A culture stays pending or preliminary until the laboratory is sure what has grown, or that nothing will grow. Fungal and tuberculosis cultures can stay pending for several weeks.
Samples that could not be tested. A sample that was too small, clotted, or leaked in transport may never produce a result. The test may need to be repeated with a new sample.

What are an addendum, an amended report, and a corrected report?

An addendum, an amended report, and a corrected report are all changes made to a pathology report after it has been issued as final. They mean different things.

Addendum. An addendum adds new information to a finished report without changing what was already written. It is most often used for biomarker or molecular results that arrive after the report was signed. Some laboratories call it a supplementary report.
Amended report. An amended report changes the content of the original report. This might change the diagnosis or add new information that changes how the original findings are understood. The change is clearly labeled, and your doctor is informed.
Corrected report. A corrected report fixes an error, such as a wrong measurement, a typing mistake, or missing details. Some laboratories use “amended” and “corrected” interchangeably.

When a laboratory issues an addendum, amended report, or corrected report, your portal may show the result as updated or pending again for a short time. The original wording is kept on record, so your full report shows what changed and when.

Will my diagnosis change when the additional results come back?

In most cases, additional test results confirm and add detail to the initial diagnosis rather than change it. When cancer is already seen on routine slides, extra tests usually describe it more precisely, such as its exact type or biomarkers.

Sometimes additional testing does change the diagnosis, which is why it is done before treatment decisions are made. If the report was still pending, the new results become part of the final report. If the report was already final, we issue a diagnosis change as an amended report rather than an addendum.

What should I do if my results still say “pending”?

If your results still say “pending,” start with the clinic or doctor who ordered the test. Laboratories often cannot discuss results with patients directly, but your clinic can see which part of your report or test is still pending and why.

Ask what is still pending. Your clinic can tell you whether the main result is finished and which tests are still outstanding.
Ask when to expect it. Your doctor’s office should be able to give you a rough date for the final report.
Ask whether next steps can start. Imaging or referrals can sometimes begin while biomarker results are pending.
Ask about getting a copy. You have the right to a copy of your own final report, and your clinic or the hospital’s medical records department can explain how to get it.

A pending or preliminary report is incomplete by definition. If you can see parts of it, review it with your doctor so you have the full picture once every result is final.

Questions to ask your doctor

Is my report final, or is any part of it still pending?
What test is still pending, and why was it ordered?
When do you expect the final report, and who will contact me?
Why does my portal still say pending if you already have my result?
Is my sample being tested here, or was it sent to another laboratory?
Has my case been sent for a second opinion?
Could the additional results change my diagnosis?
Can any next steps in my care begin while I wait?
Will the new results come as an addendum or an updated report?
If my test was never done, do I need to repeat it?