A bone marrow biopsy is a diagnostic procedure to obtain solid and liquid samples from the bone marrow for analysis. It is performed for evaluating blood disorders, cancers, infections, or unexplained abnormal blood counts.

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Indications and Purpose

  • Used to diagnose conditions like leukemia, lymphoma, multiple myeloma, anemia, unexplained fevers, and to monitor or stage cancers.ncbi.nlm.nih+1

  • Provides information on cellularity, structure, and involvement of disease in marrow that cannot be seen in blood alone.clevelandclinic+1

Preparation

  • Patient is positioned (usually prone or lateral decubitus) to expose the sampling site, typically the posterior iliac crest.hemonc+2

  • The area is cleaned thoroughly (often with antiseptic swabs) and sometimes marked.ncbi.nlm.nih+1

  • Local anesthesia is applied, and light sedation may be offered for comfort..mayoclinic+1

Equipment

  • Bone marrow kit includes sterile drapes, aspirate needles, biopsy needle (often Jamshidi type), syringes, specimen containers, and slides for pathological evaluation.hemonc+1

Procedure Steps

Aspiration

  • A small incision is made after anesthesia.mayoclinic

  • A hollow needle is inserted into the bone using anatomical or imaging guidance.ncbi.nlm.nih

  • Liquid marrow is aspirated with a syringe; patients may feel sharp pain or pressure.mayoclinic+1

  • Multiple samples may be taken if needed.mayoclinic

Biopsy (Core Sample)

  • A larger needle (often Jamshidi) is inserted at the same or slightly angled site.hemonc+2

  • Needle is twisted in alternating directions while advancing to cut the solid core of marrow.pathologyoutlines+2

  • Upon entering marrow, the sample is removed and preserved using slides or formalin containers.ncbi.nlm.nih+1

  • The ideal tissue sample is at least 1–2 cm in length.hemonc+1

Post-Procedure Care

  • Pressure applied to site, then bandaged.mayoclinic

  • Patient may lie on their back for 10–15 minutes; if sedated, recovery area is used.mayoclinic

  • Bandage must be kept dry for 24 hours; avoid soaking the area.mayoclinic

  • Pain, tenderness, and mild bruising may persist for a few days.hemonc+1

Risks and Complications

  • Low risk for bleeding and infection.ncbi.nlm.nih+1

  • Contact healthcare providers for uncontrolled bleeding, swelling, redness, drainage, worsening pain, or fever.mayoclinic

Special Notes

  • CT guidance may be used in complex cases or alternative sites in young children and certain adults.ncbi.nlm.nih

  • Typical sample site is the pelvic bone because of safety and adequate tissue amount.hemonc+2

Bone marrow biopsy is a safe and essential test for diagnosing a range of hematologic and oncologic disorders, performed under controlled sterile conditions by specialists.clevelandclinic+3

  1. https://www.mayoclinic.org/tests-procedures/bone-marrow-biopsy/about/pac-20393117
  2. https://www.ncbi.nlm.nih.gov/books/NBK559232/
  3. https://hemonc.org/wiki/Bone_marrow_biopsy_procedure_instructions_and_information
  4. https://my.clevelandclinic.org/health/diagnostics/17735-bone-marrow-biopsy
  5. https://emedicine.medscape.com/article/207575-technique
  6. https://www.pathologyoutlines.com/topic/bonemarrowneoplasticbiopsyprocedure.html
  7. https://www.mdanderson.org/cancerwise/bone-marrow-biopsy-explained--process--pain-management-and-results.h00-159700701.html

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