Journal of Leukemia
Open Access

The Pathologic Characterization of Bone Marrow Aspiration and Biopsy

David Stephen^{* *}Correspondence: David Stephen, Department of Oncology and Surgery, Adama Science and Technology University, Adama, Ethiopia, Email:

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Description

The pathologic analysis of bone marrow samples obtained by bone marrow biopsy (often called as trephine biopsy) and bone marrow aspiration is known to as bone marrow examination. Leukemia, multiple myeloma, lymphoma, anemia, and pancytopenia just are a few of the diseases that may be detected through a bone marrow testing. Blood’s cellular constituents, such as platelets, red blood cells, and white blood cells, are created in the bone marrow. While testing blood which has been drawn from a vein using phlebotomy can provide a lot of information, in which blood cells are produced, to learn further about hematopoiesis. This is the function of bone marrow aspiration and biopsy. By using a trephine or executing an aspiration, bone marrow samples can be collected. A bone marrow examination may include both an aspirate and a biopsy. The aspirate produces semi-liquid bone marrow that can be inspected under a microscope by a pathologist and examined by chromosome analysis, flow cytometry, or Polymerase Chain Reaction (PCR). Frequently, a trephine biopsy is also conducted, which outcomes in a narrow, spherical solid piece of bone marrow that really is 2 mm wide and 2 cm long (80 L). This piece is then under a microscope for cellularity and infiltrative processes (sometimes with the help of immunohistochemistry). A 20 mL syringe aspiration provides roughly 300 L of bone marrow.

It is not recommended to use a volume greater than 300 L as it could dilute the sample with peripheral blood. Usually, the posterior iliac crest, or the back of the hipbone, is the site of a trephine biopsy and bone marrow aspiration. The sternum can also be utilized to obtain an aspirate (breastbone).

The pathologic characterization of bone marrow aspiration and biopsy in the patient lies on their back for the sternal aspirate while having a pillow placed under one shoulder to lift the chest. Because of the risk of injuring blood vessels, the lungs, or the heart, a trephine biopsy should never be performed on the sternum. While spinous process aspiration is frequently performed in the lumbar puncture position and on the L3-L4 vertebrae, bone marrow aspiration may also be done on the tibial (shinbone) site in children up to 2 years of age. Anesthesia is used to alleviate surface pain where the needle is put. Short-term discomfort from the anesthesia procedure itself may occur, as well as pain from the operation's damage to the marrow, which cannot be anaesthetized. The patient experience is not constant; some patients report no pain at predicted periods while others report pain at various densities. A bone marrow biopsy can be performed in a doctor's office or a hospital. In most cases, informed consent is essential for the procedure. The patient is advised to lie on their side or stomach (in the prone position) (lateral decubitus position). A anesthesia, such as lidocaine or procaine, is injected after skin has been cleaned properly. Although it is not normal practice, patients may sometimes be given analgesics and/or anti-anxiety drugs before surgery.

The aspirate is normally carried out first. Manual pressure and force are used to insert an aspirate needle through the skin until it abuts the bone. The needle is then inserted through the bony cortex (the hard outer layer of the bone) and into the marrow cavity by twisting the clinician's hand and wrist. A syringe is attached and used to aspirate ("suck out") liquid bone marrow once the needle is in the marrow cavity. To avoid excessive blood content in the sample, which might happen if an excessively large sample is collected from a single location, a twisting motion is used during aspiration. If needed, the biopsy is then performed out. The bony cortex is penetrated with a new, bigger trephine needle. A solid piece of bone marrow is then remove by twisting the needle as it is advanced. This piece, along with the needle, is then removed. Once preparation is complete, the entire process typically lasts 10 to 15 minutes. To avoid blood coagulation if several samples are taken, the needle is taken out between each sample.

After the procedure, the patient is usually asked to lie flat for 5-10 minutes to exert pressure to the procedure site. If no bleeding is seen at this time, the patient can get up and resume their normal activities. Soreness is common for 2-3 days after the procedure and can be relieved with paracetamol (commonly known as acetaminophen) or other simple analgesics.

A complication may well be suggested by worsening pain, redness, fever, bleeding, or edema. Further, patients are advised not to wash the procedure site for at least 24 hours after the procedure. While minor pain for 12-24 hours after a bone marrow test is usual, major consequences are extremely rare. An estimated 55,000 bone marrow exams were performed, according to a major review, and 26 serious adverse events (0.05%), including one fatality, were recorded. While rare, the complications in this report were serious in some of the cases.