Bone marrow biopsy
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A bone marrow biopsy is a medical procedure used as part of a test in the diagnosis of several conditions including leukemia. A biopsy is a method of removing a small tissue sample from the body to have it examined under a microscope and possibly analyzed by other tests. Bone marrow is soft tissue found inside some of the larger bones in the body. The marrow produces platelets, red blood cells and white blood cells.
How the test is performed
The bone marrow biopsy may be done in the health care provider's office or in a hospital. The sample is usually taken from the hip bone or posterior iliac crest. The patient is usually asked to lie on his or her abdomen (prone position). The skin is cleansed, and a local anesthetic such as lidocaine is injected to numb the area. Patient may also be pretreated with opiate analgesics and/or antianxiety medications.
The biopsy needle is then inserted into the bone. The core of the needle will then be removed, and the needle is pressed forward and rotated in both directions. This forces a tiny sample of the bone marrow into the needle. The needle is then removed. Pressure is applied to the biopsy site to stop bleeding, and a bandage is applied.
An aspirate may also be performed, usually before the biopsy is taken. After the skin is anesthetized, the aspirate needle is inserted into the bone, and a syringe is used to withdraw the liquid bone marrow. If this is performed, the needle will be removed and either repositioned, or another needle may be used for the biopsy.
The aspirate is occasionally taken from the sternum, but this is less common. It is still used on occasion, particularly in extremely obese individuals, with a special stop on the needle to keep it from piercing all the way through the sternum and damaging the heart underneath. Core biopsies are never performed on the sternum.
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