[Second opinions and reference pathology]

Second opinions in pathology require expert knowledge for diagnosis in difficult cases and in Germany have a tradition that has grown into a network between primarily diagnostic care institutions and university-associated institutes of pathology that are active in research. The term reference pathology is not a designation for a class of institutes for pathology but rather indicates a function within prospective clinical trials with defined endpoints and a central pathology, which derives expert knowledge from this function. The thus generated collection of samples and expertise enable diagnostic support in difficult cases. Furthermore, research based on this tissue material might lead to the establishment of novel biomarkers and methods, which when transferred back for local application will enhance the overall diagnostic validity of pathological tissue analysis. Thus, for all institutes participating in the network second opinion and reference pathology provide considerable benefit.