Bone Marrow (cont.)
What is a bone marrow procedure?
A bone marrow procedure (commonly referred to as a bone
marrow or bone marrow aspiration) is a technique used to obtain the
blood-forming portion
(marrow) of the inner core of bone for examination in the laboratory
or for transplantation. The bone marrow consists of inserting a
special needle into a bone that contains marrow and withdrawing the
marrow by suction or coring out a sample of the marrow.
Why are bone marrows done?
Most bone marrows are performed to diagnose various conditions
that affect the different types of blood cells. Abnormal blood counts can lead a doctor to suspect that there may be a problem in the bone marrow. Another frequent purpose of a bone marrow is
to diagnose certain cancers or to determine the extent of the cancer
(cancer staging) within the bone marrow. Bone marrow procedures can also detect uncommon conditions, including abnormal proteins (such as in amyloidosis), inflammation (such as in sarcoidosis), and infection (such as in tuberculosis). This procedure can also be used to obtain marrow
for transplantation.
What bone is used to sample the bone marrow?
The most frequent site for obtaining bone marrow is the
pelvic bone, known as the ilium. A portion of this bone is readily
accessible in most people from the lower back and is usually marked
by shallow dimples on either side of the spine. Other sites include
the front of the pelvic bone near the groin and the sternum
at the front of the chest.
How is a bone marrow performed?
Typically, only a local anesthetic is required to numb the skin
and tissue down to the surface of the bone. A small cut (less than
one-quarter inch) is then made in the skin. A special needle is used to
penetrate through the dense outer shell of bone. Once inside the
bone, the center portion of this needle (the trochar) is removed and
a syringe is attached. The bone marrow is withdrawn by pulling back
on the plunger of the syringe and collecting the liquid. This sample
is known as the marrow aspirate. This part of the procedure only
lasts a few seconds, but is usually the most painful due to the sudden
stimulation of small nerves inside the bone.
A biopsy can also be obtained in addition to the marrow aspirate
or when an aspirate cannot be obtained. The same needle is used but
without the center portion in place. As the needle is twisted through
the bone it cuts a core which is trapped inside the needle. Once
the needle is removed, this core can be extracted from the needle
barrel. This core can then be prepared with fixatives and stains for examination under a microscope.
Since the skin cut for a bone marrow procedure is usually very small, no stitches are
generally necessary and only a bandage is applied.
Next: What is done with the bone marrow sample? »
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