Bone Marrow Biopsy

Bone marrow biopsy are procedures to collect and examine bone marrow — the spongy tissue inside some of your larger bones. It can show whether your bone marrow is healthy and making normal amounts of blood cells. Doctors use these procedures to diagnose and monitor blood and marrow diseases, including some cancers, as well as fevers of unknown origin.

Bone marrow has a fluid portion and a more solid portion. In bone marrow aspiration, a needle is used to withdraw a sample of the fluid portion. In bone marrow biopsy, a needle is used to withdraw a sample of the solid portion.

Bone marrow biopsy can be performed alone, but it’s usually combined with bone marrow aspiration. Together, these procedures may be called a bone marrow exam.

A bone marrow exam offers detailed information about the condition of your bone marrow and blood cells.

Orthopedic Surgeon practicing at Shreya Hospital in Ghaziabad may order a bone marrow exam if blood tests are abnormal or don’t provide enough information about a suspected problem.

Your doctor may perform a bone marrow biopsy to:

• Diagnose a disease or condition involving the bone marrow or blood cells
• Determine the stage or progression of a disease
• Determine whether iron levels are adequate
• Monitor treatment of a disease
• Investigate a fever of unknown origin

A bone marrow biopsy may be used for many conditions. These include:

• Anemia
• Blood cell conditions in which too few or too many of certain types of blood cells are produced, such as leukopenia, leukocytosis, thrombocytopenia, thrombocytosis, pancytopenia and polycythemia
• Cancers of the blood or bone marrow, including leukemias, lymphomas and multiple myeloma
• Cancers that have spread from another area, such as the breast, into the bone marrow
• Hemochromatosis
• Fevers of unknown origin

Procedure

A bone marrow aspiration and biopsy can be done in a hospital, clinic or doctor’s office.

The procedures are usually done by a doctor who specializes in blood disorders (hematologist) or cancer (oncologist). But bone marrow exams may also be performed by nurses with special training.

Before the procedure

Your blood pressure and heart rate will be checked, and you’ll be given some form of anesthesia to keep you comfortable.

A bone marrow examination can be done with only local anesthesia to numb the area where the needles will be inserted. With local anesthesia, bone marrow aspiration, in particular, can cause brief, but sharp, pain. Many people choose to also have light sedation for additional pain relief.

If you’re anxious about pain, you may be given an IV medication so that you’re either completely or partially sedated during the bone marrow exam.

The area where the biopsy needles will be inserted is marked and cleaned with an antiseptic. The bone marrow fluid (aspirate) and tissue sample (biopsy) are usually collected from the top ridge of the back of a hipbone (posterior iliac crest). Sometimes, the front of the hip may be used.

You’ll be asked to lie on your abdomen or side, and your body will be draped with cloth so that only the exam site is showing.

Rarely, bone marrow aspiration — but not biopsy — is collected from the breastbone or, in children under the age of 12 to 18 months, from the lower leg bone.

Bone Marrow Aspiration

The bone marrow aspiration is usually done first. The doctor or nurse makes a small incision in the skin, then inserts a hollow needle through the bone and into the bone marrow.

Using a syringe attached to the needle, a sample of the liquid portion of the bone marrow is withdrawn. You may feel a brief sharp pain or stinging. The aspiration takes only a few minutes. Several samples may be taken.

The health care team checks the sample to make sure it’s adequate. Rarely, fluid can’t be withdrawn and the needle is moved for another attempt.

Bone Marrow Biopsy

The doctor or nurse uses a larger needle to withdraw a sample of solid bone marrow tissue. The biopsy needle is specially designed to collect a core (cylindrical sample) of bone marrow.

After the procedure

Pressure will be applied to the area where the needle was inserted to stop the bleeding. Then a bandage will be placed on the site.

If you had local anesthesia, you’ll be asked to lie on your back for 10 to 15 minutes and apply pressure to the biopsy site. You can then leave and go about your day, returning to normal activity as soon as you feel up to it.

If you had IV sedation, you’ll be taken to a recovery area. Plan to have someone drive you home, and take it easy for 24 hours.

You may feel some tenderness for a week or more after your bone marrow exam. Ask your doctor about taking a pain reliever, such as acetaminophen (Tylenol, others).