Bone marrow biopsy
A bone marrow biopsy is the removal of soft tissue, called marrow, from inside bone. Bone marrow is found in the hollow part of most bones. It helps form blood cells.
Biopsy - bone marrow
How the test is performed
A bone marrow biopsy may be done in the health care provider's office or in a hospital. The sample may be taken from the pelvic or breast bone. Sometimes, other areas are used.
The health care provider will clean the skin and inject a numbing medicine into the area. Rarely, you may be given medicine to help you relax.
The doctor inserts the biopsy needle into the bone. The center of the needle is removed and the hollowed needle is moved deeper into the bone. This captures a tiny sample, or core, of bone marrow within the needle. The sample and needle are removed. Pressure and a bandage are applied to the biopsy site.
A bone marrow aspirate may also be performed, usually before the biopsy is taken. After the skin is numbed, the needle is inserted into the bone, and a syringe is used to withdraw the liquid bone marrow. If this is done, the needle will be removed and either repositioned, or another needle may be used for the biopsy.
How to prepare for the test
Tell the health care provider:
- If you are allergic to any medications
- What medications you are taking
- If you have bleeding problems
- If you are pregnant
You must sign a consent form.
How the test will feel
You will feel a sharp sting when the numbing medicine is injected. You may feel a brief, sharp pain when the liquid (aspirate) is removed.
The biopsy needle may also cause a brief, usually more dull, pain. Since the inside of the bone cannot be numbed, this test may cause some discomfort. However, not all patients have such pain.
Why the test is performed
Your doctor may order this test if you have abnormal types or numbers of red or white blood cells or platelets on a complete blood count (CBC).
This test is used to diagnose leukemia, infections, some types of anemia, and other blood disorders. It may also be used to help determine if a cancer has spread or responded to treatment.
A normal result means the bone marrow contains the proper number and types of blood-forming (hematopoietic) cells, fat cells, and connective tissues.
What abnormal results mean
Abnormal results may be due to cancers of the bone marrow (leukemia or Hodgkin's disease).
The results may detect the cause of anemia (too few red blood cells), abnormal white blood cells, or thrombocytopenia (too few platelets).
Additional conditions under which the test may be performed:
- Disseminated coccidioidomycosis (a body-wide fungal infection)
- Hairy cell leukemia
- Hodgkin's lymphoma
- Idiopathic aplastic anemia
- Multiple myeloma
- Myelodysplastic syndrome (MDS)
- Non-Hodgkin's lymphoma
- Polycythemia vera
- Primary amyloid
- Primary myelofibrosis
- Primary thrombocythemia
- Secondary aplastic anemia
- Secondary systemic amyloid
- Waldenstrom's macroglobulinemia
What the risks are
There may be some bleeding at the puncture site. More serious risks, such as serious bleeding or infection, are very rare.
This test is often performed when there are problems with the various types of blood cells. The person may be at increased risk for bleeding, infection, or other problems.
Hutchison RE, McPherson RA, Schexneider KI. Basic examination of blood and bone marrow. In McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia,Pa: Saunders Elsevier; 2011:chap 30.
Kaushansky K. Hematopoiesis and hematopoietic growth factors. In Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia,PA: Saunders Elsevier; 2011:chap 159.
Last reviewed 6/5/2012 by David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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