Bone marrow examination

Bone marrow examination is a medical procedure that involves the study of bone marrow, the soft, spongy tissue found in the interior of bones. This examination is crucial for diagnosing and monitoring various hematological (blood-related) and oncological (cancer-related) conditions. The procedure is typically performed by a hematologist or an oncologist and involves two main techniques: bone marrow aspiration and bone marrow biopsy.

Bone Marrow Aspiration

Bone marrow aspiration involves the removal of a small amount of liquid bone marrow, usually from the posterior iliac crest (back of the hip bone), using a needle. This procedure allows for the examination of the types of cells in the bone marrow, their number, and morphology. It is particularly useful for diagnosing conditions such as leukemia, anemia, and infections.

Bone Marrow Biopsy

A bone marrow biopsy is often performed in conjunction with the aspiration. It involves the extraction of a small, solid piece of bone marrow tissue. This technique is essential for evaluating the architecture of the bone marrow and is crucial for diagnosing diseases such as lymphomas and fibrosis.

Indications

Bone marrow examination is indicated for:

• Diagnosis of hematological diseases such as leukemia, lymphoma, and multiple myeloma.
• Evaluation of fever of unknown origin.
• Assessment of iron stores in cases of anemia.
• Staging of cancers that may spread to the bone marrow.
• Monitoring response to therapy in hematological diseases.

Procedure

The procedure for a bone marrow examination typically involves the following steps:

1. The patient is positioned either lying on their side or stomach.
2. The skin over the biopsy site is cleaned, and a local anesthetic is applied to numb the area.
3. A special biopsy needle is inserted through the skin and into the bone marrow cavity.
4. For aspiration, a syringe is attached to the needle to draw out liquid marrow. For biopsy, a core of marrow is extracted.
5. The needle is removed, and pressure is applied to the site to stop any bleeding.

Risks and Complications

While bone marrow examination is generally safe, it may involve certain risks and complications such as:

• Pain and discomfort at the biopsy site.
• Bleeding.
• Infection.
• Rarely, a fracture of the bone if the needle is not correctly inserted.

Aftercare

Following the procedure, patients are advised to:

• Keep the biopsy site clean and dry.
• Monitor for signs of infection.
• Avoid strenuous activities for a few days.

Interpretation of Results

The results of a bone marrow examination are interpreted by a pathologist. The findings can provide valuable information about the presence of diseases, the stage of a disease, and the response to treatment. Abnormal results may indicate conditions such as anemia, infections, blood cancers, and marrow fibrosis.