BONE
MARROW
BIOPSY
Bone Marrow
• Bone marrow is located inside the hollow center of your larger bones. Bone
marrow consists of soft, sponge-like tissue and a liquid.
• The tissue part of bone marrow produces
Red Blood cells, White Blood cells, Platelets
• The liquid part of bone marrow contains stem cells, or maturing blood cells. It
also makes vitamins needed for cell production.
• While a bone marrow biopsy tests the tissue part of your bone marrow, a
separate procedure called a bone marrow aspiration tests the liquid portion.
BONE MARROW BIOPSY
• A bone marrow biopsy is a procedure that involves removing a
sample of bone marrow and testing it for signs of disease.
• It is used to to diagnose blood disorders, cancer and many other
conditions that may affect your bone marrow
• The procedure lasts around 30 minutes
SITES
• STERNUM
• ILIAC CREST
• SPINOUS PROCESS OF LUMBAR VERTEBRAE
• POSTERIOR SUPERIOR ILIAC SPINE
• ANTERIOR SUPERIOR ILIAC SPINE
Infants and young children
• Upper end of Tibia
MATERIALS REQUIRED
• Xylocaine (1%)
• Syringes and needles
• Biopsy needles
• Stylet
• Microscopic slide
• EDTA bottle
BIOPSY NEEDLES
• Jamshidi needle
• Islam needle
• Westerman-Jensen needle
PARTS OF BIOPSY NEEDLE
1. Hub: The part of the needle that attaches to the syringe or handle.
2. Shaft: The long, thin part of the needle that penetrates the skin and bone.
3. Tip or Point: The sharp end of the needle that enters the skin and bone.
4. Stylet: A thin, rod-like instrument that is inserted into the needle to help guide it and prevent bone
marrow from entering the needle prematurely.
5. Cannula: The hollow tube that makes up the shaft of the needle, allowing for the collection of bone
marrow.
6. Handle: The part of the needle that is held by the healthcare professional performing the biopsy.
TECHNIQUE
Procedure Bone marrow biopsy from Posterior Iliac crest
• Place the patient in the lateral position with the top leg flexed and the lower ley straight
• Clean the site with iodine followed by spirit
• Infiltrate 1% Xylocaine at the site of aspiration
• Make a small 3mm Cut with a surgical blade on the skin
• Insert the biopsy needle through this cut with a stylet to reach bone marrow cavity to
obtain an adequate bone marrow specimen measuring 1.5 – 2 cm in length.
• Slowly pull the needle out and remove the specimen from the needle
• Make marrow imprint smear
• Place the specimen in 10% formalin for histopathology
• After procedure an adhesive dressing is done at the site of puncture.
• Prepare 2 peripheral smear by finger prick method.
Preparation of bone marrow smear
Imprint smear
The core of the bone marrow is rolled between 2 glass slides.
Biopsy Imprint
INDICATIONS
• A bone marrow biopsy may be indicated for various conditions such as ;
1. Aplastic anaemia
2. Myelodysplastic syndrome
3. Bone marrow Transplantation
4. In cases of PUO- for tuberculos
granuloma
5. AIDS
6. Fever of unknown orgin
Parasites commonly detected in
biopsy
Protozoa:
Leishmania spp. (Leishmaniasis)
Trypanosoma cruzi (Chagas disease)
Plasmodium spp. (Malaria – in severe or chronic cases)
Helminths:
Echinococcus granulosus (Hydatid disease)
Strongyloides stercoralis (Strongyloidiasis) – in disseminated infections
Leishmaniasis
Causative agent: Leishmania spp.
Bone marrow involvement: Common in visceral leishmaniasis
Microscopic findings:
• Intracellular amastigotes within macrophages
Chagas Disease
• Causative agent: Trypanosoma cruzi
Bone marrow involvement: Rare
Microscopic findings:
• Trypomastigotes may be seen in blood smears or bone marrow aspirates
Malaria
Causative agent: Plasmodium spp.
Bone marrow involvement: In severe or chronic cases
Microscopic findings:
• Ring forms, trophozoites, and schizonts may be seen in bone marrow smears
• Hydatid Disease
• Causative agent: Echinococcus granulosus
• Bone marrow involvement: Rare
• Microscopic findings:
• Hydatid cysts or fragments may be seen in bone marrow sections
Strongyloidiasis
Causative agent: Strongyloides stercoralis
Bone marrow involvement: In disseminated infections
Microscopic findings:
• Larvae may be seen in bone marrow aspirates or sections
_____________________________________________________________________
Submitted
by
Pranav M
II BSc MLT
Roll no : 16
