BONE MARROW BIOPSY

Image Source: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/bone-marrow-biopsy

What is bone marrow examination?

It’s a test performed to study the bone marrow.

There are two types of test; bone marrow aspiration and biopsy.

Bone marrow aspiration means to withdraw the fluid portion of the marrow and the bone marrow biopsy means to take out a piece of bone core with the help of a wide bore needle.

What are the indication of bone marrow examination?

For diagnosis, staging and monitoring of response of treatment in various blood cancers
To rule out metastasis
For evaluation of various blood disorders like low blood counts, unexplained anemias,
Evaluation of iron status
For unexplained fever

What are the contraindication?

There is no absolute contraindication. But there are relative contraindications.
Hemophilia
DIC severe bleeding disorder
Severe thrombocytopenia

How it is performed?

After obtaining Informed and written consent for the procedure, patient is either taken to the procedure room or in the ICU or any other place depending upon the individual hospital practice. It can be done under local anesthesia or under sedation.

When it is done under sedation, patient tolerates the procedure well and are more comfortable. For sedation, patient is usually kept NBM for minimum of 6hour time.

Patient is asked to sleep in lateral decubitus.

Local part is prepared with aseptic solution for aseptic procedure and draping is done to cover the rest of the area.

After local anesthesia or sedation, bone marrow aspiration needle is inserted into the bone marrow and blood is aspirated and collected into the vacutainers as needed.

For biopsy, the biopsy needle is inserted through the same incision and advanced into the bone with twisting movement until it is firmly fixed. After removal of the stylet again the needle is advanced further than it is again slowly with twisting movement removed back.

The bony tissue is collected into the saline cup.

After the procedure, dressing is applied.

Report usually takes 3 to 5day time to come, depending upon the laboratory facility.