Bone marrow biopsy
Biopsy - bone marrowA bone marrow biopsy is the removal of marrow from inside bone. Bone marrow is the soft tissue inside bones that helps form blood cells. It is found in the hollow part of most bones.
Biopsy
A biopsy is the removal of a small piece of tissue for laboratory examination.
Read Article Now Book Mark ArticleBone marrow biopsy is not the same as bone marrow aspiration. An aspiration removes a small amount of marrow in liquid form for examination.
Bone marrow aspiration
Bone marrow is the soft tissue inside bones that helps form blood cells. It is found in the hollow part of most bones. Bone marrow aspiration is th...
Read Article Now Book Mark ArticleHow the Test is Performed
A bone marrow biopsy may be done in the health care provider's office or in a hospital. The sample may be taken from the pelvic or breast bone. Sometimes, another area is used.
Marrow is removed in the following steps:
- If needed, you are given medicine to help you relax.
- The provider cleans the skin and injects numbing medicine into the area and surface of the bone.
- A biopsy needle is inserted into the bone. The center of the needle is removed and the hollowed needle is moved deeper into the bone. This captures a tiny sample, or core, of bone marrow within the needle.
- The sample and needle are removed.
- Pressure and then a bandage are applied to the skin.
A bone marrow aspiration may also be done, usually before the biopsy is taken. After the skin is numbed, the needle is inserted into the bone, and a syringe is used to withdraw the liquid bone marrow. If this is done, the needle will be removed and repositioned. Or, another needle may be used for the biopsy.
How to Prepare for the Test
Tell the provider:
- If you are allergic to any medicines
- What medicines you are taking
- If you have bleeding problems
- If you are pregnant
How the Test will Feel
You will feel a sharp sting when the numbing medicine is injected. The biopsy needle may also cause a brief, usually dull, pain. Since the inside of the bone cannot be numbed, this test may cause some discomfort.
If a bone marrow aspiration is also done, you may feel a brief, sharp pain as the bone marrow liquid is removed.
Why the Test is Performed
Your provider may order this test if you have abnormal types or numbers of red or white blood cells or platelets on a complete blood count (CBC).
Complete blood count
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
Read Article Now Book Mark ArticleThis test is used to diagnose:
- Anemia (some types)
- Infections
- Leukemia
- Other blood cancers and disorders
It may also be used to help determine if a cancer has spread or responded to treatment.
Normal Results
A normal result means the bone marrow contains the proper number and types of blood-forming (hematopoietic) cells, fat cells, and connective tissues.
What Abnormal Results Mean
Abnormal results may be due to cancers of the bone marrow (leukemia, lymphoma, multiple myeloma, or other cancers).
The results may detect the cause of anemia (too few red blood cells), abnormal white blood cells, or thrombocytopenia (too few platelets).
Thrombocytopenia
Thrombocytopenia is any disorder in which there is an abnormally low amount of platelets. Platelets are parts of the blood that help blood to clot. ...
Read Article Now Book Mark ArticleSpecific conditions for which the test may be performed:
- A body-wide fungal infection (for example, disseminated coccidioidomycosis)
Disseminated coccidioidomycosis
Valley fever is an infection that occurs when the spores of the fungus Coccidioides immitis enter your body through the lungs.
Read Article Now Book Mark Article - A white blood cell cancer called hairy cell leukemia
Hairy cell leukemia
Hairy cell leukemia (HCL) is an unusual cancer of the blood. It affects B lymphocyte cells, a type of white blood cell.
Read Article Now Book Mark Article - Cancer of the lymph tissue (Hodgkin or non-Hodgkin lymphoma)
Hodgkin
Hodgkin lymphoma is a cancer of lymph tissue. Lymph tissue is found in the lymph nodes, spleen, liver, bone marrow, and other sites.
Read Article Now Book Mark ArticleNon-Hodgkin lymphoma
Non-Hodgkin lymphoma (NHL) is cancer of the lymph tissue. Lymph tissue is found in the lymph nodes, spleen, and other organs of the immune system. W...
Read Article Now Book Mark Article - Bone marrow doesn't make enough blood cells (aplastic anemia)
Aplastic anemia
Aplastic anemia is a condition in which the bone marrow does not make enough blood cells. Bone marrow is the soft, tissue in the center of bones tha...
Read Article Now Book Mark Article - Blood cancer called multiple myeloma
Multiple myeloma
Multiple myeloma is a blood cancer that starts in the plasma cells in the bone marrow. Bone marrow is the soft, spongy tissue found inside most bone...
Read Article Now Book Mark Article - Group of disorders in which not enough healthy blood cells are made (myelodysplastic syndrome; MDS)
- A nerve tissue tumor called neuroblastoma
Neuroblastoma
Neuroblastoma is a very rare type of cancerous tumor that develops from nerve tissue. It usually occurs in infants and children.
Read Article Now Book Mark Article - Bone marrow disease that leads to an abnormal increase in blood cells (polycythemia vera)
Polycythemia vera
Polycythemia vera (PV) is a bone marrow disease that leads to an abnormal increase in the number of blood cells. The red blood cells are the most af...
Read Article Now Book Mark Article - Abnormal protein buildup in tissues and organs (amyloidosis)
Amyloidosis
Primary amyloidosis is a rare disorder in which abnormal proteins build up in tissues and organs. Clumps of the abnormal proteins are called amyloid...
Read Article Now Book Mark Article - Bone marrow disorder in which the marrow is replaced by fibrous scar tissue (myelofibrosis)
Myelofibrosis
Myelofibrosis is a disorder of the bone marrow in which the marrow is replaced by fibrous scar tissue.
Read Article Now Book Mark Article - Bone marrow produces too many platelets (thrombocythemia)
Thrombocythemia
Essential thrombocythemia (ET) is a condition in which the bone marrow produces too many platelets. Platelets are particles in the blood that aid in...
Read Article Now Book Mark Article - White blood cell cancer called Waldenström macroglobulinemia
Waldenström macroglobulinemia
Waldenström macroglobulinemia (WM) is a cancer of the B lymphocytes (a type of white blood cell). WM is associated with the overproduction of protei...
Read Article Now Book Mark Article - Unexplained anemia, thrombocytopenia (low platelet count) or leukopenia (low WBC count)
Risks
There may be some bleeding at the puncture site. More serious risks, such as serious bleeding or infection, are very rare.
References
Bates I, Burthem J. Bone marrow biopsy. In: Bain BJ, Bates I, Laffan MA, eds. Dacie and Lewis Practical Haematology. 12th ed. Philadelphia, PA: Elsevier; 2017:chap 7.
Chernecky CC, Berger BJ. Bone marrow aspiration analysis-specimen (biopsy, bone marrow iron stain, iron stain, bone marrow). In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:241-244.
Choby BA. Bone marrow aspiration and biopsy. In: Fowler GC, ed. Pfenninger and Fowler's Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 220.
Vajpayee N, Graham SS, Bem S. Basic examination of blood and bone marrow. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 31.
Bone marrow aspiration - illustration
A small amount of bone marrow is removed during a bone marrow aspiration. The procedure is uncomfortable, but can be tolerated by both children and adults. The marrow can be studied to determine the cause of anemia, the presence of leukemia or other malignancy, or the presence of some storage diseases, in which abnormal metabolic products are stored in certain bone marrow cells.
Bone marrow aspiration
illustration
Bone biopsy - illustration
A bone biopsy is performed by making a small incision into the skin. A biopsy needle retrieves a sample of bone and it is sent for examination. The most common reasons for bone lesion biopsy are to distinguish between benign and malignant bone tumors, and to identify other bone abnormalities. Bone biopsy may also be performed to determine the cause of bone pain and tenderness.
Bone biopsy
illustration
Bone marrow aspiration - illustration
A small amount of bone marrow is removed during a bone marrow aspiration. The procedure is uncomfortable, but can be tolerated by both children and adults. The marrow can be studied to determine the cause of anemia, the presence of leukemia or other malignancy, or the presence of some storage diseases, in which abnormal metabolic products are stored in certain bone marrow cells.
Bone marrow aspiration
illustration
Bone biopsy - illustration
A bone biopsy is performed by making a small incision into the skin. A biopsy needle retrieves a sample of bone and it is sent for examination. The most common reasons for bone lesion biopsy are to distinguish between benign and malignant bone tumors, and to identify other bone abnormalities. Bone biopsy may also be performed to determine the cause of bone pain and tenderness.
Bone biopsy
illustration
Review Date: 4/29/2022
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.