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Bone Marrow (cont.)

What is done with the bone marrow sample?

The bone marrow core biopsy is first placed in a liquid that keeps the cells in their natural condition (fixative solution). The sample is then placed in a solution to soften the bone and is finally processed like other biopsies in the tissue study (histology) laboratory. The liquid portion of the bone marrow is spread on glass slides and stained to make the bone marrow smears. The slides are then examined under the microscope, usually by a specially qualified technician or physician such as a hematologist or pathologist.

Portions of either sample may be submitted to the microbiology laboratory for cultures. Certain conditions may require other specialized studies such as genetic testing or cell marker studies.

What diseases are diagnosed by bone marrow examination?

A wide variety of conditions can be diagnosed by examination of the bone marrow. The following examples illustrate some of the most frequent conditions, but there are many more. The presence or absence of cancer in the bone marrow can determine what treatments are recommended to a patient with cancer known to be elsewhere in the body. Some cancers (leukemia, multiple myeloma) arise from cells in the marrow so this is where the biopsy must be taken to confirm the diagnosis. A low blood-clotting element (platelet count) in the blood (thrombocytopenia) can be due to several causes. It is important to establish whether or not the cells that make the platelets (megakaryocytes) are still present in the marrow (idiopathic thrombocytopenic purpura [ITP]) or are gone (along with most other bone marrow cells as in aplastic anemia). Most cases of anemia (low red blood cells) can be diagnosed by simple blood tests. When these tests are negative, examining the marrow can reveal problems with the red blood cells that are uncommon causes of anemia (sideroblastic anemia, aplastic anemia). Persistent fevers can be caused by infections that reside in the marrow (atypical mycobacteria, brucellosis) and a sample of the marrow may provide the best source of culture material.

Medically Reviewed by a Doctor on 2/10/2014

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