Content
Bone marrow biopsy is an examination performed with the aim of assessing the characteristics of bone marrow cells and is therefore often used to help doctors make diagnoses and monitor the evolution of diseases such as lymphoma, myelodysplasias or multiple myeloma, as well as to search for infections or to identify whether there are metastases from other types of tumors to this location.
Bone marrow biopsy is indicated by a hematologist or oncologist and is usually done to complement bone marrow aspirate, called a myelogram, especially when this test fails to provide enough information about bone marrow in a given disease.
Bone marrow biopsy can be quite uncomfortable, as the test is done by collecting a sample of the pelvic bone, which is why it is done under local anesthesia that helps to reduce discomfort.
What is it for
Bone marrow biopsy is a very important test, as it provides information about the quantity and characteristics of the cells that make up the bone marrow. In this way, the test will detect whether the spinal cord is empty or excessively full, if there are deposits of undue substances, such as iron or fibrosis, as well as observing the presence of any other abnormal cells.
Thus, bone marrow biopsy can be used in the diagnosis or monitoring of some diseases, such as:
- Hodgkin's and non-Hodgkin's lymphomas;
- Myelodysplastic syndrome;
- Chronic myeloproliferative diseases;
- Myelofibrosis;
- Multiple myeloma and other gammopathies;
- Identification of cancer metastases;
- Aplastic anemia and other causes of decreased spinal cord cellularity not clarified;
- Essential thrombocythaemia;
- Research into the causes of infectious processes, such as chronic granulomatous disease;
In addition, bone marrow biopsy can also be performed with the aim of identifying the stage of some types of cancer and monitoring the progress of the disease.
Most of the time, the bone marrow biopsy is done together with the myelogram, which is done from the collection of a blood sample from the bone marrow and which aims to evaluate the characteristics of the blood cells produced by the marrow. Understand what the myelogram is and how it is done.
How it is done
The spinal biopsy procedure can be done in the doctor's office, in the hospital bed or in the operating room, depending on the patient's health status. It is done under local anesthesia, however, in some cases mild sedation may be necessary, especially in children or patients who are unable to collaborate with the exam.
This procedure is usually done on the pelvic bone, in a place called the iliac crest, but in children it can be performed on the tibia, a leg bone. Usually, the exam is done right after the collection of the bone marrow aspirate, which can be collected in the same place.
During the exam, the doctor inserts a thick needle, specially developed for this exam, through the skin until it reaches the inner part of the bone, from where a sample of the bone fragment of about 2 cm is taken. Then, this sample will be placed in laboratory slides and tubes and will be analyzed by the hematologist or pathologist.
Risks and care after the exam
Bone marrow biopsy is a safe procedure and rarely brings complications such as bleeding and bruising on the skin, but it is common for the patient to feel pain during the exam and up to 1 to 3 days later.
The patient can resume normal activities a few minutes after the exam, preferably he should rest on the day of the exam. There is no need to modify the diet or use of medications, and the dressing at the location of the needle stick can be removed between 8 and 12 hours after the exam.