Bone Marrow Biopsy

None.

• To obtain a piece of bone containing intact marrow to study for abnormalities.
• To help diagnose erythrocytosis, thrombocythemia, and some kinds of anemia.
• To diagnose or determine the stage of tumors or lymphoma.
• To determine the underlying cause of an unexplained fever.
• To diagnose fibrosis of the marrow and myeloma when aspiration attempts have failed (called a "dry tap").

Cellular relationships to other cells and the cellular makeup of the marrow can be determined under a microscope with a biopsy because the architecture of the sample is maintained (as opposed to an aspiration, in which the sample is smeared in its preparation).

You are given a sedative if you choose.

• You receive a local anesthetic at the needle puncture site (in adults, the hip bone; in children, a vertebra or long bone in the leg).
• A large-bore needle is forced through the outer cortex of the bone, about ³/₄ of an inch deep. The needle is rotated clockwise and counter-clockwise, withdrawn slightly, reintroduced at a slightly different angle, and rotated again. This process continues until the core is sheared off.
• The needle is removed, again in a rotating motion, and wire is pushed through the tip of the needle to force the specimen onto sterile gauze. A slide is then made.
• Sometimes a biopsy is done immediately preceding or following an aspiration.

• Direct pressure is applied to control bleeding at the needle site, and the area is covered with a sterile dressing.
• Depending on the location of the biopsy, you may have to lie on your back for at least 30 minutes before getting dressed.
• Some pain or soreness will occur at the site, but you should be able to resume normal activities almost immediately.
• If possible, the site should be examined by a nurse or physician about 24 hours later.

• Obesity.
• Moving during the procedure.
• Radiation therapy at the insertion site.
• Severe coagulation or other clotting or bleeding disorders.

The sample is analyzed under a microscope for the makeup of cells, the distribution and maturation of cell constituents, and the ratio of red to white blood cells. Arrested development of blood cell precursors or abnormal numbers of cells may indicate leukemia; while a markedly depleted marrow supply may indicate hypoplastic or aplastic anemia, which is incapable of producing sufficient blood cells.

• It's quick.
• There are relatively few complications.

• It's an invasive procedure that may cause pain.
• It's difficult to do in very obese people.
• It yields a small sample of marrow.

Treatment for the problem identified by the biopsy can begin.