152:
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446:(the hard outer layer of the bone) and into the marrow cavity. Once the needle is in the marrow cavity, a syringe is attached and used to aspirate ("suck out") liquid bone marrow. A twisting motion is performed during the aspiration to avoid excess content of blood in the sample, which might be the case if an excessively large sample from one single point is taken. Subsequently, the biopsy is performed if indicated. A different, larger
327:
462:(aka acetaminophen) or other simple analgesics can be used to ease soreness, which is common for 2–3 days after the procedure. Any worsening pain, redness, fever, bleeding or swelling may suggest a complication. Patients are also advised to avoid washing the procedure site for at least 24 hours after the procedure is completed.
40:
312:
Anesthesia is used to reduce surface pain at the spot where the needle is inserted. Pain may result from the procedure's insult to the marrow, which cannot be anesthetized, as well as short periods of pain from the anesthetic process itself. The experience is not uniform; different patients report
450:
needle is inserted and anchored in the bony cortex. The needle is then advanced with a twisting motion and rotated to obtain a solid piece of bone marrow. This piece is then removed along with the needle. The entire procedure, once preparation is complete, typically takes 10–15 minutes.
457:
After the procedure is complete, the patient is typically asked to lie flat for 5–10 minutes to provide pressure over the procedure site. After that, assuming no bleeding is observed, the patient can get up and go about their normal activities.
192:) for cellularity and infiltrative processes. An aspiration, using a 20 mL syringe, yields approximately 300 μL of bone marrow. A volume greater than 300 μL is not recommended, since it may dilute the sample with peripheral blood.
188:(PCR). Frequently, a trephine biopsy is also obtained, which yields a narrow, cylindrically shaped solid piece of bone marrow, 2 mm wide and 2 cm long (80 μL), which is examined microscopically (sometimes with the aid of
167:
Bone marrow samples can be obtained by aspiration and trephine biopsy. Sometimes, a bone marrow examination will include both an aspirate and a biopsy. The aspirate yields semi-liquid bone marrow, which can be examined by a
309:. Bone marrow aspiration may also be performed on the tibial (shinbone) site in children up to 2 years of age while spinous process aspiration is frequently done in a lumbar puncture position and on the L3-L4 vertebrae.
486:
contraindications as long as the procedure is performed by a skilled clinician. Bone marrow aspiration and biopsy can be safely performed even in the setting of extreme
1267:
518:(0.08% of total procedures), the most common of which was bleeding. In this report, complications, while rare, were serious in individual cases.
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438:
Typically, the aspirate is performed first. An aspirate needle is inserted through the skin using manual pressure and force until it hits the
151:
1070:
348:
494:
count). If there is a skin or soft tissue infection over the hip, a different site should be chosen for bone marrow examination.
293:(breastbone). For the sternal aspirate, the patient lies on their back, with a pillow under the shoulder to raise the chest. A
1083:
Malempati, Suman; Joshi, Sarita; Lai, Susanna; Braner, Dana A.V.; Tegtmeyer, Ken (2009). "Bone Marrow
Aspiration and Biopsy".
510:(0.05%), including one fatality. The same author collected data on over 19,000 bone marrow examinations performed in the
139:), it is sometimes necessary to examine the source of the blood cells in the bone marrow to obtain more information on
17:
374:
356:
352:
506:
are extremely rare. In a large review, an estimated 55,000 bone marrow examinations were performed, with 26
1048:
eMedicine "Specialties > Hematology > Diagnostic
Procedures > Bone Marrow Aspiration and Biopsy"
281:
Bone marrow aspiration and trephine biopsy are usually performed on the back of the hipbone, or posterior
1220:"Reevaluation of reference values for bone marrow differential counts in 236 healthy bone marrow donors"
1059:
185:
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to bone marrow examination. It is important to note that thrombocytopenia or bleeding disorders are
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If several samples are taken, the needle is removed between the samples to avoid blood coagulation.
337:
61:
503:
442:. Then, with a twisting motion of clinician's hand and wrist, the needle is advanced through the
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While mild soreness lasting 12–24 hours is common after a bone marrow examination, serious
189:
135:. While much information can be gleaned by testing the blood itself (drawn from a vein by
8:
1310:
99:. Bone marrow examination is used in the diagnosis of a number of conditions, including
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1219:
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for the procedure is typically required. The patient is asked to lie on their abdomen (
237:
223:
155:
Section of bone marrow core biopsy as seen under the microscope (stained with H&E).
403:
A bone marrow biopsy may be done in a health care provider's office or in a hospital.
313:
different levels of pain, and some do not report any pain at certain expected points.
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Parmentier S, Kramer M, Weller S, Schuler U, Ordemann R, Rall G; et al. (2020).
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should never be performed on the sternum, due to the risk of injury to
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is injected to numb the area. Patients may also be pretreated with
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Aspiration does not always represent all cells since some such as
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A needle used for bone marrow aspiration, with removable stylet.
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112:
306:
246:
Explains cause of "dry tap" (aspiration gives no blood cells)
120:
439:
302:
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A volunteer donating bone marrow for scientific research.
143:; this is the role of bone marrow aspiration and biopsy.
119:. The bone marrow produces the cellular elements of the
1082:
1060:
What to Expect During a Bone Marrow
Aspirate and Biopsy
522:
Reference ranges for white blood cells in bone marrow
273:, and would thus be missed by a simple aspiration.
1272:Attribution 4.0 International (CC BY 4.0) license
1297:
219:Gives relative quantity of different cell types
1213:
1211:
1209:
1207:
1164:"Bone marrow biopsy morbidity: review of 2003"
146:
1291:eMedicine: Bone Marrow Aspiration and Biopsy
1266:: CS1 maint: multiple names: authors list (
1123:"Bone marrow biopsy morbidity and mortality"
1204:
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435:, although this is not a routine practice.
355:. Unsourced material may be challenged and
38:
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375:Learn how and when to remove this message
1071:Roswell Park Comprehensive Cancer Center
1038:
469:
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158:
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415:position). The skin is cleansed, and a
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222:Gives material to further study, e.g.
1050:. Article last updated April 7, 2008.
163:The preferred sites for the procedure
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353:adding citations to reliable sources
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24:
25:
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1140:10.1046/j.1365-2141.2003.04329.x
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1286:MedlinePlus: Bone marrow biopsy
1085:New England Journal of Medicine
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1111:
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289:can also be obtained from the
13:
1:
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1073:, n.d. Accessed 2014-08-08.
411:) or on their side (lateral
256:Does not represent all cells
7:
1009:
147:Components of the procedure
27:Form of pathologic analysis
10:
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1236:10.1007/s00277-020-04255-4
186:polymerase chain reaction
60:
37:
32:
433:anti-anxiety medications
1180:10.1136/jcp.2004.022178
83:analysis of samples of
77:Bone marrow examination
33:Bone marrow examination
1097:10.1056/NEJMvcm0804634
1026:Fine-needle aspiration
514:in 2003, and found 16
508:serious adverse events
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400:
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97:bone marrow aspiration
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399:Bone marrow aspirate.
398:
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48:bone marrow aspirate
534:Reference range (%)
349:improve this section
243:Represents all cells
190:immunohistochemistry
52:from a patient with
197:
182:chromosome analysis
1065:2016-03-04 at the
633:Polychromatophilic
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401:
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224:molecular genetics
195:
165:
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89:bone marrow biopsy
18:Bone marrow biopsy
1230:(12): 2723–2729.
1007:
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480:contraindications
466:Contraindications
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277:Site of procedure
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133:white blood cells
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16:(Redirected from
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1162:Bain BJ (2005).
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488:thrombocytopenia
417:local anesthetic
405:Informed consent
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317:Test performance
259:Slow processing
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176:and analyzed by
174:light microscope
105:multiple myeloma
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599:Proerythroblast
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295:trephine biopsy
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990:Plasma cells
754:Promyelocyte
668:Granulocytes
501:
483:
477:
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402:
371:
365:January 2017
362:
347:Please help
335:
311:
294:
286:
280:
264:
240:constitution
166:
123:, including
117:pancytopenia
96:
95:biopsy) and
88:
87:obtained by
76:
75:
1321:Bone marrow
1224:Ann Hematol
1091:(15): e28.
1016:Bone biopsy
971:Lymphocytes
840:Eosinophils
722:Neutrophils
537:Median (%)
460:Paracetamol
444:bony cortex
283:iliac crest
211:Advantages
196:Comparison
170:pathologist
85:bone marrow
1311:Hematology
1300:Categories
1032:References
864:mast cells
737:Myeloblast
616:Basophilic
531:Range (%)
429:analgesics
253:Drawbacks
203:Aspiration
137:phlebotomy
81:pathologic
901:Monocytes
860:Basophils
822:Segmented
771:Myelocyte
710:34.1–67.4
707:24.5–72.5
693:35.5–64.5
690:26.0–70.5
676:34.8–66.3
673:24.5–72.5
588:15.6–45.0
571:16.2–46.6
568:11.0–54.5
554:15.8–46.2
540:Mean (%)
421:lidocaine
413:decubitus
336:does not
271:trabecula
125:platelets
1254:32935189
1198:15790706
1149:12786808
1121:(2003).
1105:19812396
1063:Archived
1010:See also
978:5.5–23.2
975:1.0–38.5
919:ME ratio
883:GE-ratio
828:2.5–19.7
825:1.0–27.5
811:6.5–26.2
808:2.0–34.0
794:1.0–12.0
791:0.5–18.0
777:5.8–24.0
774:1.0–31.7
656:0.5–16.5
639:7.8–34.5
636:3.0–47.0
622:0.5–13.5
585:8.5–56.5
551:8.5–56.5
492:platelet
448:trephine
425:procaine
419:such as
287:aspirate
267:lymphoma
172:under a
109:lymphoma
101:leukemia
93:trephine
54:leukemia
1245:7683448
1189:1770618
1119:Bain BJ
959:0.8–4.2
956:0.6–6.2
942:0.8–4.0
939:0.6–6.1
925:0.8–4.1
922:0.6–6.2
889:0.8–4.1
886:0.5–5.9
848:0.5–7.0
842:(total)
724:(total)
670:(total)
548:(total)
431:and/or
357:removed
342:sources
305:or the
291:sternum
206:Biopsy
68:D001856
1316:Biopsy
1252:
1242:
1196:
1186:
1147:
1103:
1021:Biopsy
994:0–17.5
953:Female
845:0–18.0
704:Female
653:0–21.0
619:0–21.0
582:Female
285:. An
238:stroma
115:, and
113:anemia
997:0–7.0
984:13.6
908:0–6.0
905:0–8.5
872:0–1.5
869:0–3.0
862:(and
817:15.2
783:13.7
760:0–5.5
757:0–8.5
743:0–5.0
740:0–8.5
716:50.5
699:49.7
682:49.9
645:20.2
605:0–3.0
602:0–5.0
594:30.1
577:32.4
560:31.7
490:(low
307:heart
303:lungs
184:, or
121:blood
50:smear
1268:link
1250:PMID
1194:PMID
1145:PMID
1101:PMID
1003:2.6
981:13.2
948:1.8
936:Male
931:1.8
914:2.2
895:1.7
878:0.3
834:9.8
814:14.5
805:Band
780:13.5
766:1.3
749:1.6
696:49.5
687:Male
679:49.5
662:6.3
628:4.5
611:0.6
591:29.5
565:Male
440:bone
340:any
338:cite
226:and
216:Fast
131:and
62:MeSH
1240:PMC
1232:doi
1184:PMC
1176:doi
1135:doi
1131:121
1093:doi
1089:361
1000:2.3
962:1.7
945:1.6
928:1.6
892:1.6
851:2.5
831:9.5
797:4.5
746:1.5
659:5.5
625:3.5
608:0.5
484:not
423:or
351:by
1302::
1264:}}
1260:{{
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1238:.
1228:99
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1192:.
1182:.
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1166:.
1143:.
1129:.
1125:.
1099:.
1087:.
1069:,
1040:^
965:2
854:3
800:5
713:50
642:20
574:33
557:32
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111:,
107:,
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1256:.
1234::
1200:.
1178::
1151:.
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763:1
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