Bone Marrow
Biopsy
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What is the
test?
Doctors can diagnose many problems that cause
anemia, some infections, and some kinds of leukemia
or lymphoma cancers by examining a sample of
your bone marrow (the tissue where blood cells
are made). A bone marrow biopsy is the procedure
to collect such a sample. It is done using a
large needle inserted through the outside surface
of a bone and into the middle of the bone, where
the marrow is.
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How
do I prepare for the test?
You will need to sign a consent form giving
your doctor permission to perform this test.
Because you will probably receive some pain medicines
or anti-anxiety medications that can make you
drowsy, you will need to arrange a ride home.
Tell your doctor if you have ever had an allergic
reaction to lidocaine or the numbing medicine
used at the dentist's office. Also talk with
your doctor before the test if you are taking
insulin, or if you take aspirin, nonsteroidal
anti-inflammatory drugs, or other medicines that
affect blood clotting. It may be necessary to
stop or adjust the dose of these medicines before
your test. Most people need to have a blood test
done some time before the procedure to make sure
they are not at high risk for bleeding complications.
Usually you will be told not to eat anything
after midnight on the night before the test.
This is in case you experience nausea from the
anti-anxiety medicines.
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What
happens when the test is performed?
Most patients have this test done by a hematologist
in a clinic procedure area. You wear a hospital
gown during the procedure. A sedative may be
injected at this time. (If you are prescribed
a sedative in pill form, you will be instructed
to take it ahead of time.)
Most patients have bone marrow sampled from
the pelvis. You lie on your stomach and the doctor
feels the bones at the top of your buttock. An
area on your buttock is cleaned with soap. A
local anesthetic is injected to numb the skin
and the tissue underneath the skin in the sampling
area. This causes some very brief stinging.
A small cut is made in the skin to allow the
biopsy needle to be placed through the skin.
This needle is about half as wide as a pencil
and has a handle on one end that your doctor
holds while he or she moves it through your bone.
The biopsy needle is moved through the bone with
a twisting motion, as a corkscrew would be moved
through a cork. When the needle has passed through
the top layer of bone, your doctor uses a syringe
to pull a liquid sample of your bone marrow cells
through the needle. For most patients, the suction
used in this liquid collection causes a pain
in the buttock for a few seconds; this is why
pain medicine is usually given in preparation
for the biopsy.
After taking the liquid sample, the doctor carefully
moves the needle a little bit further into the
bone marrow to collect a second sample of marrow
called a core biopsy. This core biopsy is a small
solid piece of bone marrow, with not just the
liquid and cells but also the fat and bone fibers
that hold them together. After the needle is
pulled out, this solid sample can be pushed out
of the needle with a wire so that it can be examined
under a microscope. Pressure is applied to your
buttock at the biopsy location for a few minutes,
until you are not at risk of bleeding. A bandage
is placed on your buttock.
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What
risks are there from the test?
Risks are minimal. Having a sample taken is
not harmful for your bone or bone marrow. Injury
of nearby tissue from the biopsy is very uncommon.
You might have some buttock soreness for a few
days, and you may have some bruising at the biopsy
site. A few individuals have an allergy or a
side effect from the pain medicine or anti-anxiety
medicine.
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Must
I do anything special after the test is over?
You will feel sleepy from the medicines used
to reduce pain and anxiety. Once these medicines
have worn off (a few hours after the test), you
can return to normal activities, but you should
not drive or drink alcohol for the rest of the
day.
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How
long is it before the result of the test is
known?
The samples taken need to be treated in the
laboratory and prepared on slides that can be
seen under the microscope. Some parts of your
bone marrow biopsy report may be available within
a day, but some tests require special stains
or tests that can take longer, in some cases
up to one week.
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