Bone marrow biopsy

A Bone marrow biopsy is a diagnostic medical procedure that involves extracting a small sample of bone marrow tissue for examination. Primarily, the procedure aims to determine the presence of cancerous cells, especially plasma cells, within the marrow. A bone marrow aspiration is commonly performed concurrently with this biopsy, allowing for a comprehensive analysis of the bone marrow environment.

Blausen Bone Marrow Biopsy

The bone marrow, a soft and spongy tissue found within the interior of bones, plays a crucial role in the production of blood cells: red blood cells, white blood cells, and platelets. A biopsy of this tissue helps medical professionals assess the state of blood cell production and identify any abnormalities.

Procedure

Bone marrow tap

Bone_marrow_aspiration,_extracted_from_Hematology_(1963)

The biopsy involves using a large, hollow needle, typically inserted into the posterior iliac crest of the hip bone, although other sites can also be used depending on the patient's condition and the physician's preference. The procedure can be performed under local anesthesia, ensuring the area is numb, minimizing discomfort.

1. Steps:
2. The patient lies down, either on their side or face down.
3. The area of interest is cleaned and sterilized.
4. Local anesthesia is administered.
5. A small incision might be made to facilitate the insertion of the biopsy needle.
6. The biopsy needle is carefully inserted into the bone.
7. A cylindrical sample of bone marrow tissue is extracted.
8. The needle is removed, and the incision site is cleaned and bandaged.

Indications

A bone marrow biopsy might be indicated for:

• Detecting malignancies like leukemia or lymphomas.
• Assessing stages of certain cancers.
• Evaluating unexplained anemia or abnormal blood cells.
• Monitoring bone marrow activity and the effect of treatment on certain conditions.
• Investigating fevers of unknown origin.

Findings

Post-procedure, the extracted sample is sent to a pathology laboratory where it undergoes rigorous examination. If cancerous plasma cells are identified, the pathologist determines the extent of marrow involvement, estimating the percentage of the marrow that is affected. Other findings could include:

• Infections.
• Bone marrow disorders.
• Metabolic conditions.
• Storage diseases.

Associated Procedures

• Bone Marrow Aspiration: Often conducted alongside the biopsy, this procedure involves extracting a liquid sample of the marrow to evaluate the types and numbers of cells present.

Risks and Complications

While generally considered safe, some potential risks include:

• Bleeding at the biopsy site.
• Infection.
• Discomfort or pain.
• Reaction to anesthesia.

Patients should immediately notify their healthcare provider if they experience excessive bleeding, prolonged pain, fever, or any signs of infection.

See Also

• Bone Marrow Aspiration
• Leukemia
• Lymphoma
• Pathology

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