The diagnostic services of Pathology and Cytopathology are the backbone of patient management and also contribute significantly to basic and clinical research.  Although a large portion of the clinical workload depends on the activity of The University of Texas M.D. Anderson Cancer Center clinicians, our outside consultative service has continued independently to increase over the years.  Consultation on specimens from patients sent to M.D. Anderson Cancer Center, or second opinion cases, represent about 60% of our caseload.  The review of diagnostic material obtained and evaluated elsewhere has been shown to be of significant importance both in terms of quality of care and economic benefit.