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Bone marrow biopsy is diagnostic test for many diseases

Bone marrow is the primary site where blood products such as red cells, white cells and platelets are produced. A bone marrow biopsy is a diagnostic procedure that evaluates the deficiencies and excessive production of any one of these elements. These evaluations can diagnose a number of diseases. "For example anemia is the deficiency of hemoglobin," according to Dr. Farid U. Qazi, Board Certified Oncologist and Medical Hematologist at Dublin Hematology & Oncology Care, P.C. "Leukopenia is a low white cell count and Thrombocytopenia is a deficiency of platelets. The excess of any of these cells could be benign like a reactive cytosis or could be malignant like Leukemia's and Lymphomas."

Bone marrow is also a site where many cancer cells reside, so biopsies are used for diagnosis of the spread of cancer. "Not all cancer goes to the bone marrow", Dr. Qazi said "There are certain cancers which are known to show up in the bone marrow. The most common are breast cancer, small cell lung cancer and prostate cancer, apart from hematological cancers like Lymphoma, Myeloma and Leukemia.

Bone marrow is also used for specialized test like chromosome or genetics analysis. "For example some types of Leukemia have specific abnormality in chromosomes." Dr. Qazi said "Through testing if we do not find anything suggesting Leukemia, yet we find that specific chromosome we can accurately diagnosis the disease."

Bone marrow biopsies can be useful for cultures if the source of an infection has not been identified in a patient who has a fever.

For diagnostic purposes a biopsy is only obtained from flat bones like the hip bone or sternum.
"Early in childhood all the bone marrow throughout the body produces blood and blood products." Dr. Qazi explains "By adulthood only flat bones have marrow viable enough to reproduce."

The hip bone is the bone of choice for a biopsy because it is a large bone and an adequate sample of bone marrow can be obtained. The sternum is a sight used only for marrow examination, especially children. The disadvantage is the bone is thin and a piece can not be taken because of a risk of breaking the bone.

"Marrow is not like the jelly-like substance you find when you eat meat," Dr. Qazi said "it's just like blood."

The procedure begins with the numbing of the skin over the area to be biopsied. With the numbing there is a slight burning sensations and the prick of needle. Then a larger needle is used to numb the bone. A large needle is used to collect the marrow and bone fragment.

"The most painful part of the biopsy is when the marrow is extracted, this is also a brief part of the procedure, and fortunately it only takes a few seconds." Dr Qazi said "Other than the actual extraction the procedure should not be painful. During the procedure the patient should feel very little other than a little pressure."

A Bone marrow is only done when it is definitely needed for diagnostic purposes."We try to find the cause of a disease first, without the use of invasive means." Dr. Qazi said "Then if needed we do this procedure for confirmation."

A Bone marrow biopsy is not a standard procedure for solid tumors, it is almost a requirement to exclude or confirm a diagnosis of blood related cancers like Leukemia or Lymphomas. Bone marrow biopsy is more frequently done to diagnose non-cancer blood diseases.

The biopsy is an outpatient procedure that usually takes 20 minutes or less. "We prefer to keep the patient lying down for about half an hour after the procedure." Dr. Qazi said "After that the patient should be back to normal activity level."

In normal non-complicated procedures there are no side effects. However a small percentage of patients will suffer mild soreness for a couple of days.

"The diagnostic value of a bone marrow test mostly relies on a good interpretation."

Dr.Qazi said "We are very fortunate to have excellent pathologist in our community."