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Bone Marrow Aspiration and Biopsy

The bone marrow is one of the body's largest organs, representing 3.5 to 4.5% of the total body weight and averaging about 1500 grams in adults. The hematopoietic bone marrow is organized around the vasculature of the bone cavity. The bone marrow can be sampled relatively easily using either a needle aspirate or needle biopsy technique.

The main function of the bone marrow is to supply mature hematopoietic cells for circulating blood in a steady-state donation as well as to respond to increased physiologic or pathologic demands.

The bone marrow aspiration and bone biopsy are usually performed concurrently. Bone marrow studies aid in the diagnosis, staging, and monitoring of several diseases.

Hematologic diseases affecting primarily the bone marrow causing an increase or decrease of any of the cellular blood elements are among the most common indications for a bone marrow study. The conditions typically include:

  • Anemias, erythrocytosis, polycythemia
  • Leukopenia and unexplained leukocytosis
  • Appearance of immature and abnormal cells in the circulation
  • Thrombocytopenia and thrombocytosis.

Systemic disease may affect the bone marrow secondarily and require bone marrow studies for diagnosis and monitoring of the patient's condition. These may include:

  • Solid tumors arising elsewhere in the body, such as lymphoma, carcinoma, and sarcoma, may metastasize to the bone marrow. Patients having any of these solid tumors may undergo bone marrow studies when the initial diagnosis is established for evaluation of the degree of tumor spread and/or clinical staging of the patient's disease.
  • Infections manifested clinically as "fever of unknown origin" may exhibit granulomas, focal necrosis, or histiocytic proliferation with intracytoplasmic organisms within the marrow.
  • Hereditary and acquired histiocytosis occasionally involve the bone marrow. Examples include Gaucher's disease, sea-blue histiocytosis, and hemophagocytic syndrome.

Bone marrow aspirations and/or bone marrow biopsies can be performed in physicians' offices, outpatient clinics and/or hospital settings. It is extremely important, however, to deliver the bone marrow sample to the proper anticoagulants or fixative for optimal preservation of the cellular detail and optimal interpretation of the patient's findings. Generally speaking, testing of the bone marrow sample must be performed within 24 hours of collection.

Outpatient bone marrow requirements
Physician office collection
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