Surgical Pathology Consult Service

The Surgical Pathology Consult Service has a “growing problem” — but unlike the condition for which a popular commercial proposes a cure, our growing problem is greatly welcome!

Under the medical directorship of Dr. Jonathan Epstein for more than 10 years, the service provides world-renowned expertise in Pathology second opinion consultations.  In 1990, the Surgical Pathology Consult staff consisted of three individuals who processed approximately 4,500 cases sent for review from outside institutions. Today, under the leadership of Linda Parsons and the supervision of Rose Voeglein, we comprise eleven people and receive over 36,000 cases from institutions and patients across the globe.

There are a number of reasons why outside material is sent to Johns Hopkins: pathologists from other facilities may need our assistance in rendering a diagnosis; clinicians may require our expertise in order to decide on a course of treatment; patients may want a second opinion from Hopkins to verify a diagnosis; or patients may be seeking treatment here, and their diagnosis must be confirmed before Hopkins physicians initiate it.

Fed Ex, UPS, and other courier services deliver packages to Reed Hall, Room 315, all day, with the bulk of the packages delivered between 9:30 and 10:30 every morning. Consult coordinators open the packages, set up the slides in trays, and verify that that the material the outside facility says it sent are actually received. On the accompanying paperwork, they review and highlight the information to be entered in the computer – name, date of birth, outside specimen number, etc. – all the while making sure there are no discrepancies in the pathology material, reports, demographics or billing information.

Other coordinators enter the data into the computer system, and re-verify that we have received all the right information. They print a gross description for each case, label all the paperwork, slides and blocks, and every hour the accessioned cases are sent to the pathologists via our courier.

The majority of the material we receive is from the male genitourinary tract. The rest of the cases come from a wide range of specimen types, such as head and neck, breast, pancreas, and the gastrointestinal tract to name a few. Expert pathologists from virtually all specialties are available to examine each case, and unless additional studies are required, provide a diagnosis within two to three days of the receipt of the material.

Once the cases have been reviewed and signed out, the slides and blocks are sent back to our office for return to the original institutions.

Obviously, the Consult Service is a vital link in Johns Hopkins Hospital’s mission to provide world-class medical expertise. The dedication of the consult staff that supports the pathologists is evident in the quality of our service. For more information on submitting a consult: