Bone marrow biopsy

Alternative names
Biopsy - bone marrow

Bone marrow is soft tissue found inside some of the larger bones in the body. The marrow produces platelets and red and white blood cells. 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.

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. The skin is cleansed, and a local anesthetic is injected to numb the skin.

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.

How to prepare for the test
Inform the health care provider if you have allergies to any medications, about which medications you are taking, and if you have bleeding problems. The health care provider should also know if you are pregnant. You must sign a consent form.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child’s age, interests, previous experiences, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child’s age:

  • Infant test or procedure preparation (birth to 1 year)  
  • Toddler test or procedure preparation (1 to 3 years)  
  • Preschooler test or procedure preparation (3 to 6 years)  
  • Schoolage test or procedure preparation (6 to 12 years)  
  • Adolescent test or procedure preparation (12 to 18 years)

How the test will feel
There will be a sharp stinging from the anesthetic injection. As the aspirate is withdrawn, there may be a brief, sharp pain. The biopsy needle may also produce a brief pain, usually more dull. Since the interior of the bone cannot be anesthetized, this test may cause some discomfort. Not all patients experience these symptoms, however.

Why the test is performed

The test is done after abnormal types or numbers of red or white blood cells are found in a complete blood count, or to evaluate whether other systemic diseases are present in the bone marrow.

The examination may detect the cause of the abnormality, certain types of anemia (not enough red blood cells), cancer in the marrow, and may be used to monitor the response to therapy for some cancers.

Normal Values
The marrow has normal cells that are the correct types and numbers.

What abnormal results mean
The results may indicate 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:

  • Coccidioidomycosis; disseminated  
  • Hairy cell leukemia  
  • Hodgkin’s lymphoma  
  • Idiopathic aplastic anemia  
  • Multiple myeloma  
  • Neuroblastoma  
  • Non-Hodgkin’s lymphoma  
  • Polycythemia vera  
  • Primary amyloid  
  • Primary myelofibrosis  
  • Primary thrombocythemia  
  • Secondary aplastic anemia  
  • Secondary systemic amyloid

What the risks are
Persistent bleeding and infection are rare and can be controlled.

Special considerations
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.

Johns Hopkins patient information

Last revised: December 5, 2012
by David A. Scott, M.D.

Medical Encyclopedia

  A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | 0-9

All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.