Bone Marrow Examination - Components of The Procedure

Components of The Procedure

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 pathologist under a light microscope and analyzed by flow cytometry, chromosome analysis, or polymerase chain reaction (PCR). Frequently, a trephine biopsy is also obtained, which yields a narrow, cylindrically shaped solid piece of bone marrow, 2mm wide and 2 cm long (80 μL), which is examined microscopically (sometimes with the aid of immunohistochemistry) 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.

Comparison
Aspiration Biopsy
Advantages
  • Fast
  • Gives relative quantity of different cell types
  • Gives material to further study, e.g. molecular genetics and flow cytometry
  • Gives cell and stroma constitution
  • Represents all cells
  • Explains cause of "dry tap" (aspiration gives no blood cells)
Drawbacks Does not represent all cells Slow processing

Aspiration does not always represent all cells since some such as lymphoma stick to the trabecula, and would thus be missed by a simple aspiration.

Read more about this topic:  Bone Marrow Examination

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