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What is the bone marrow biopsy? | Medical tests

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Through a puncture with a fine needle in a bone it allows to study with depth hematologic diseases.

Bone marrow biopsy

Bone marrow is a soft and spongy tissue that is located on the inside of the bones in our body. Its main function is to hold the stem cells that are responsible for the production of blood cells: red blood cells, white blood cells, and platelets. Bone marrow biopsy involves taking a piece of this fabric together with a suction of blood that irrigates it through a puncture in the bone.
It is a test that is often carried out for the study of hematologic diseases such as anaemia, tumours and rare diseases. Thanks to it, have been achieved cure diseases that at the beginning of the 20th century were considered untreatable.
Their risks are similar to those of other types of biopsy and, however, the majority of the people has a special fear to be held because it is related to pain. Actually the bone marrow biopsy is a test that causes some pain, but current techniques have much diminished damage caused before, both in intensity and duration (only lasts a few seconds).
Although it appears that the bone marrow has a difficult access, is it easily reachable through superficial bones with a fine needle. It is an invasive technique, but little aggressive, and is performed easily without the need of a hospital admission. It takes less than half an hour and allows you to understand the disease of the patient with depth to provide you with the most appropriate treatment.

When a bone marrow biopsy is done

Bone marrow biopsy is a test that is carried out or requested when the following alterations in a person:
Anemia of unknown cause: Although the most frequent causes of anaemia lack of iron or of specific vitamins, sometimes the reason is not known there are a low number of red blood cells in the blood. A bone marrow biopsy would know if there is a primary disturbance in blood stem cells.
Leukopenia: in the same way that anemia is decrease of red blood cells in blood, leukopenia is the decrease of white blood cells in blood. A transient leukopenia may appear in specific situations of infection in elderly people, but most of the time indicates a primary disease of the bone marrow that one must study.
Thrombocytopenia: thus calls the decline in the number of platelets in the blood. Their decline may be due to external diseases, but when they have ruled out the bone marrow should be studied to see what is the main cause of the thrombocytopenia.
Bone marrow Aplasia: is the combination of anemia, leukopenia, and thrombocytopenia. The bone marrow is consumed until already it can not produce any blood cell more.
Leukemia: one of the most common tumors of the white blood cells. Leukemia can be diagnosed through a blood test, but it is important to know if there is involvement of the bone marrow to know its gravity.
Lymphoma: another also frequent tumor of the white cells. In this case the first organs affected are the lymph nodes, but you can also pass into the blood and thus affect the bone marrow.
Multiple myeloma: is a tumor of the white cells type B that are responsible for producing antibodies that defend us against infections. This tumour appears initially in the bone marrow and the biopsy helps to know its features.
Myelofibrosis: in this disease the bone marrow atrophy until it literally dry. The biopsy is not possible because there is no fabric, but precisely by performing this test ensures the diagnosis.
Polycythemia vera: it is the polar opposite of anemia, here red blood cells are excessive and they make blood viscous. So blood flow is dense and slows metabolism, among other symptoms.
Infections: some infections affect in particular cells progenitors of blood. One of them is visceral leishmaniasis, a parasitic disease relatively common in exotic regions of Asia and South America.
Amyloidosis: occurs when certain proteins of the organism are synthesized evil, so that they cease to be soluble, and accumulate in organs throughout the body. The primary form is diagnosed with a bone marrow biopsy.
Cell therapy: currently, treatment with stem cell research is booming. Many of these therapies are based on extracting stem cells from the bone marrow, modify them in the laboratory and implanted them in other areas of the body. He is currently a therapy study of which is not known its effectiveness.

How bone marrow biopsy

First, the doctor will assess in a consultation if necessary or not performing a bone marrow biopsy. If deemed necessary will inform you of why it thinks, how it's performed, what information we can provide and what are the possible risks. It will give you an informed consent document summarizing the main characteristics and you will have to sign it if you agree with its realization.
Bone marrow biopsy may make you it the same day or in another different appointment. When going to ask you in the first place that you change your clothes and views a comfortable gown for you and for the doctor that perform you the test. Then will measure you all vital signs such as blood pressure, heart rate, respiratory rate and temperature, to check that you are in optimal conditions to put you to the test.
Sometimes placed you a via vein in the arm if it had introduced some medically during the conduct of the test, although it is not common. Sometimes will offer you some relaxing drug remain sedated during the test, it is recommended if you are nervous or have you are particularly sensitive to pain.
Prepared once you will be asked you to tumbes on a stretcher in a position that facilitates the realization of the test. The bones where usually do the biopsy are the sternum (in the center of the chest), the iliac Crest (at the hip), tibia (in the leg) and vertebrae (on the back). Usually take the biopsy of the iliac Crest, if there are no impediments, so ask you that you place lying on side and to relax.
To proceed with the biopsy, the first thing that will is clean the skin where it is made with alcohol or iodine compounds. So remove any contaminants germs from the skin surface. Then they will inject an anesthetic and most deep from the surface. You will feel a slight prick of the needle, and then a burning sensation at the very moment in which the anesthesia gets. Thus, this area of the body will be asleep and insensitive.
Then they entered a long needle to reach the bone and go through it, then you will notice a pressure very strong in bone, for some people is painful and for others is simple intense pressure. The first needle will carry out a vacuum to pick up blood and loose cells, then take a small cylinder of tissue.
Once the biopsy needles be removed. It is normal that the puncture point blood slightly, apply continued pressure for a few minutes to stop the bleeding. Then they placed an bandage or a compression dressing and you'll be ready to go home. It will not need to wait the results since they need to be processed for a time and at a glance not seen any alteration. The bandage must hold for at least two days, is normal in the days after the test to have pain in the area and need to take some pain reliever you your doctor will prescribe.

Complications of bone marrow biopsy

All biopsies have risks to be evidence that invade the body organs, albeit slightly. They tend to be infrequent complications and in the majority of cases have easy solutions. They can appear during or after the test, whenever they arise should go to the emergency room.
Some of the most common complications in bone marrow biopsy are:
  • Bleeding from the point of biopsy.
  • Local infection with fever.
  • Uncontrollable pain.
  • Reaction to anesthesia during the test.
  • Perforation of other organs (very unlikely).

Preparation for bone marrow biopsy

If you are performing a bone marrow biopsy these are issues you must keep in mind to go well prepared to test:
Duration: the test will last a total of 15 to 20 minutes. The biopsy itself will be one minute, the rest consists of the preparation of the material and biopsy area.
Income: bone marrow biopsy can be a query or a room of cures, in such a way that it does not require hospital admission.
Is necessary to be accompanied?: it is not necessary to be accompanied, but yes it is recommended, as there are sensitive people who are sore or something queasy after the test.
Drugs: don't need to take any prior medication. You should tell your doctor all the medicines taken regularly and will decide if we will suspend any. It is important to also inform of allergies to medications or other products, if you have them.
Food: it is not necessary to remain in fasting prior to testing or after. Take a light meal and avoid taking all day coffee, alcohol and other exciting substances, including also the day prior to the test. If for any reason it should go on fasting to test the doctor you warn.
Clothes: you can perform the test with the same clothes every day. When you get to the hospital or doctor can give you a gown to change you should see fit, although often is enough to discover the part of the body that goes to biopsiarse.
Documents: is essential to bring with you the steering wheel which shows the performance of this test. The health insurance card is recommended. Normally you will not you any document after the test because it takes time to analyze the results.
Pregnancy and breast-feeding: bone marrow biopsy is not contraindicated during pregnancy or during lactation, but that State should know because some biological constants that are studied will be altered from itself during these stages.
Contraindications: this type of biopsy does not have any specific contraindication.

Bone marrow biopsy results

The bone marrow biopsy results may take from one week up to a month. The waiting time, it therefore tends to be long and requires patience and tranquility. The reason is that the sample biopsied can not be analyzed at the time. The following analysis will be carried out on this sample:
Histological staining: using special dyes cells are colored and can be observed under the microscope directly.
Immunofluorescence studies: you can attach fluorescent substances to certain components of the cells and thus verify its existence.
Microbiological cultures: If infection is suspected sample can be grown in appropriate media that allow the growth of microorganisms.
Molecular studies: specific proteins that classified the types of cells that contain the sample can be identified.
All of these tests will be performed by the physician. Along with the symptoms, analytical studies and biopsy the doctor will already have sufficient information most of the times to be able to make a diagnosis. So you can explain what happens to you, and what are the treatments available to solve your disease.
Published for educational purposes
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