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Medical Disability Advisor  >  Bone Marrow Biopsy

Bone Marrow Biopsy


Related Terms


  • Biopsy of the Bone Marrow
  • Iliac Crest Tap
  • Sternal Tap

Specialists


  • Family Practice Physician
  • General Surgeon
  • Hematologist
  • Oncologist

Comorbid Conditions


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Factors Influencing Duration


Length of disability may be influenced by the underlying condition for which the biopsy was performed, the site of the biopsy, or the development of complications.

Medical Codes


ICD-9-CM:
41.3 - Diagnostic Procedures on Bone Marrow and Spleen
41.31 - Bone Marrow Biopsy

Definition


A bone marrow biopsy is a procedure that collects a sample of the bone marrow, the spongy substance found in the center of large bones. The bone marrow produces most components of the blood, such as red blood cells, white blood cells, and platelets. Consequently, this procedure is useful in the diagnosis of disorders of the blood or bone. Typically, the procedure includes bone marrow aspiration (a sampling of the liquid material) and biopsy (a sampling of the more solid material).

Source: Medical Disability Advisor



Reason for Procedure


Bone marrow biopsy is used in the diagnosis of a variety of disorders of the blood or blood-forming organs. The procedure may be used to evaluate iron shortage disorders and to diagnose or aid in the explanation of a decrease in the number of red blood cells (aplastic and macrocytic anemias) or a decrease in white blood cells (leukopenia) or platelets (thrombocytopenia). Bone marrow biopsy may be used in the diagnosis of primary hematological cancers (leukemias, lymphoma, or myeloma), to assess infiltration of the marrow by tumors originating in other areas of the body (i.e., breast and lung), and to follow the progress of therapy in anemias and leukemias. Additionally, a bone marrow biopsy may be indicated in cases that suggest replacement of normal bone marrow by fibrosis (myelofibrosis), to identify inflammations (parasitic, mycological, or bacterial) that may involve the marrow, or to diagnose lipid storage disease.

Source: Medical Disability Advisor



How Procedure is Performed


The skin is cleansed, and a local anesthetic is administered at the site of the biopsy (usually the back of the pelvic bone [iliac crest] or, less commonly, the breastbone [sternum]). The bone marrow aspiration involves insertion of a long, thin needle allowing the suction of marrow into a syringe. The bone biopsy procedure uses a thicker needle with a hollow core. The needle is inserted into the bone, rotated to the right and then to the left, withdrawn, and reinserted at a different angle. This sequence may be repeated until a small, solid core of bone marrow tissue chip is separated from the bone marrow and drawn into the needle. After the needle is removed, a piece of fine wire threaded through its tip transfers the specimen onto sterile gauze. The individual may experience discomfort or pressure when the needle is inserted and a brief pulling sensation accompanied by momentary dull pain when the marrow is withdrawn. To conclude the procedure, pressure is applied to the biopsy site to stop bleeding, and a bandage is used to cover the site.

The specimen is then prepared for microscopic examination that may include freezing, chemically treating, slicing, and/or staining. A pathologist or hematologist may examine the prepared specimen.

Source: Medical Disability Advisor



Prognosis


Generally, the procedure is tolerated well. The overall prognosis varies according to the diagnosis, severity of the disorder, and treatment required.

Source: Medical Disability Advisor



Complications


Complications may include bleeding at the biopsy site, infection, or a localized blood-filled swelling from a broken blood vessel (hematoma). In rare instances, the heart or a major blood vessel is pierced when marrow is extracted from the sternum. This can lead to severe, profuse bleeding (hemorrhage).

Source: Medical Disability Advisor



Return to Work (Restrictions / Accommodations)


Work restrictions and accommodations are not usually associated with this procedure.

Source: Medical Disability Advisor



General References


Falck, Troy M., and Campbell Darilyn Falck. "Bone Marrow Biopsy." eMedicine Consumer Health. Eds. Rex B. G. Cabaltica, et al. 13 Jul. 2004. Medscape. 19 May 2005 <http://www.emedicinehealth.com/articles/4945-1.asp>.

Source: Medical Disability Advisor






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