Skip to main content

Advertisement

SpringerLink
Log in

Bone marrow aspiration and biopsy: techniques and practice implications

  • Review Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Bone marrow aspiration and biopsy (BMAB) is a valuable diagnostic procedure commonly performed for evaluation of a wide spectrum of diseases including hematologic abnormalities, nonhematologic malignancies, metabolic abnormalities, and tumor treatment response such as chemotherapy and bone marrow transplantation, hematologic tumor staging, and suspected infection in patients with fever of unknown origin. This minimally invasive intervention offers excellent safety profile and a high diagnostic yield. Radiologists should be familiar with clinical implications of BMAB for patient care and be able to implement various technical armamentarium available to achieve a safe intervention while maximizing procedure yield.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Bain BJ. Bone marrow aspiration. J Clin Pathol. 2001;54:657–63.

    Article  CAS  Google Scholar 

  2. Bain BJ. Bone marrow trephine biopsy. J Clin Pathol. 2001;54:737–42.

    Article  CAS  Google Scholar 

  3. Moid F, DePalma L. Comparison of relative value of bone marrow aspirates and bone marrow trephine biopsies in the diagnosis of solid tumor metastasis and Hodgkin lymphoma: institutional experience and literature review. Arch Pathol Lab Med. 2005;129(4):497.

    Article  Google Scholar 

  4. Hamid GA, Hanibala N. Comparison of bone marrow aspiration and bone marrow biopsy in neoplastic disease. Gulf J Oncol. 2009;6:41–4.

    Google Scholar 

  5. Joshi R, Horncastle D, Elderfield K, Lampert I, Rahemtulla A, Naresh KN. Bone marrow trephine combined with immunohistochemistry is superior to bone marrow aspirate in follow-up of myeloma patients. J Clin Pathol. 2008;61(2):213–6.

    Article  CAS  Google Scholar 

  6. Lee SH, Erber WN, Porwit A, Tomonaga M, Peterson LC. ICSH guidelines for the standardization of bone marrow specimens and reports. Int J Lab Hematol. 2008;30(5):349–64.

    Article  Google Scholar 

  7. Kaur M, Singh Rana AP, Kapoor S, Puri A. Diagnostic value of bone marrow aspiration and biopsy in routine hematology practice. J Clin Diagn Res. 2014;8(8):FC13–6.

    PubMed  PubMed Central  Google Scholar 

  8. Riley RS, Hogan TF, Pavot DR, et al. Pathologist’s perspective on bone marrow aspiration and biopsy: I. performing a bone marrow examination. J Clin Lab Anal. 2004;18:70–90.

    Article  Google Scholar 

  9. Jain S, Enzerra M, Mehta RS, Smith R, Djokic M. Bone marrow biopsies performed by both the powered OnControl drill device and the Jamshidi needle produce adequate specimens. J Clin Pathol. 2017;70(6):541–3.

    Article  Google Scholar 

  10. Schnapauff D, Marnitz T, Freyhardt P, et al. CT guided bone biopsy using a battery powered intraosseous device. Cardiovasc Intervent Radiol. 2013;36(5):1405–10.

    Article  Google Scholar 

  11. Stensby JD, Long JR, Hillen TJ, Jennings JW. Safety of bone marrow aspiration and biopsy in severely thrombocytopenic patients. Skeletal Radiol. 2020. https://doi.org/10.1007/s00256-020-03623.

    Article  PubMed  Google Scholar 

  12. Long JR, Stensby JD, Wiesner EL, Bryson WN, Hillen TJ, Jennings JW. Efficacy and safety of bone marrow aspiration and biopsy using fluoroscopic guidance and a drill-powered needle: clinical experience from 775 cases. Eur Radiol. 2020;30(11):5964–70.

    Article  Google Scholar 

  13. Liu B, Limback J, Kendall M, et al. Safety of CT-guided bone marrow biopsy in thrombocytopenic patients: a retrospective review. J Vasc Interv Radiol. 2017;28(12):1727–31.

    Article  Google Scholar 

  14. Tomasian A, Hillen TJ, Jennings JW. Bone biopsies: what radiologists need to know. AJR Am J Roentgenol. 2020;215(3):523–33.

    Article  Google Scholar 

  15. Hyun BH, Stevenson AJ, Hanau CA. Fundamentals of bone marrow examination. Hematol Oncol Clin North Am. 1994;8:651–63.

    Article  CAS  Google Scholar 

  16. Diebold J, Molina T, Camilleri-Broet S, Le Tourneau A, Audouin J. Bone marrow manifestations of infections and systemic diseases observed in bone marrow trephine biopsy review. Histopathology. 2000;37:199–211.

    Article  CAS  Google Scholar 

  17. Kilby JM, Marques MB, Jaye DL, et al. The yield of bone marrow biopsy and culture compared with blood culture in the evaluation of HIV-infected patients for mycobacterial and fungal infections. Am J Med. 1998;104:123–8.

    Article  CAS  Google Scholar 

  18. Benito N, Nunez A, de Gorgolas M, et al. Bone marrow biopsy in the diagnosis of fever of unknown origin in patients with acquired immunodeficiency syndrome. Arch Intern Med. 1997;157:1577–80.

    Article  CAS  Google Scholar 

  19. Penchansky L. Bone marrow biopsy in the metastatic work-up of solid tumors in children. Cancer. 1984;54:1447–8.

    Article  CAS  Google Scholar 

  20. Pittaluga S, Tierens A, Dodoo YL, Delabie J, De Wolf-Peeters C. How reliable is histologic examination of bone marrow trephine biopsy specimens for the staging of non-Hodgkin lymphoma? A study of hairy cell leukemia and mantle cell lymphoma involvement of the bone marrow trephine specimen by histologic, immunohistochemical, and polymerase chain reaction techniques. Am J Clin Pathol. 1999;111:179–84.

    Article  CAS  Google Scholar 

  21. Cheung NK. Detecting neuroblastoma using bone marrow aspiration and bone marrow biopsy. J Pediatr Hematol Oncol. 2000;22:86–8.

    Article  CAS  Google Scholar 

  22. Valdes-Sanchez M, Nava-Ocampo AA, Palacios-Gonzalez RV, et al. Diagnosis of bone marrow metastases in children with solid tumors and lymphomas. Aspiration, or unilateral or bilateral biopsy? Arch Med Res. 2000;31:58–61.

    Article  CAS  Google Scholar 

  23. Sale GE, Buckner CD. Pathology of bone marrow in transplant recipients. Hematol Oncol Clinics North Amer. 1988;2:735–56.

    Article  CAS  Google Scholar 

  24. van den Berg H, Kluin PM, Vossen JM. Early reconstitution of haematopoiesis after allogeneic bone marrow transplantation: a prospective histopathological study of bone marrow biopsy specimens. J Clin Pathol. 1990;43:365–9.

    Article  Google Scholar 

  25. Liso V, Albano F, Pastore D, et al. Bone marrow aspirate on the 14th day of induction treatment as a prognostic tool in de novo adult acute myeloid leukemia. Haematologica. 2000;85:1285–90.

    CAS  PubMed  Google Scholar 

  26. Islam A. A new sternal puncture needle. J Clin Pathol. 1991;44(8):690–1.

    Article  CAS  Google Scholar 

  27. Douglas DD, Risdall RJ. Bone marrow biopsy technic. Artifact induced by aspiration. Am J Clin Pathol. 1984;82:92–4.

    Article  CAS  Google Scholar 

  28. Brynes RK, McKenna RW, Sundberg RD. Bone marrow aspiration and trephine biopsy. An approach to a thorough study. Am J Clin Pathol. 1978;70:753–9.

    Article  CAS  Google Scholar 

  29. Friedlis MF, Centeno CJ. Performing a better bone marrow aspiration. Phys Med Rehabil Clin N Am. 2016;27(4):919–39.

    Article  Google Scholar 

  30. Forwood KM, Lee E, Crispin PJ. Comparison of the bone marrow trephine sample quality between On Control drill system and the Jamshidi needle. Int J Lab Hematol. 2019;41(3):373–9.

    Article  Google Scholar 

  31. Bain BJ. Bone marrow biopsy morbidity and mortality. Br J Heamatol. 2003;121(6):949–51.

    Article  Google Scholar 

  32. Bain BJ. Morbidity associated with bone marrow aspiration and trephine biopsy - a review of UK data for 2004. Haematologica. 2006;91(9):1293–4.

    PubMed  Google Scholar 

  33. Roth JS, Newman EC. Gluteal compartment syndrome and sciatica after bone marrow biopsy: a case report and review of the literature. Am Surg. 2002;68:791–4.

    PubMed  Google Scholar 

  34. Chamisa I. Fatal vascular retroperitoneal injury following bone marrow biopsy. S Afr Med J. 2007;97:246.

    PubMed  Google Scholar 

  35. Berber I, Erkurt M, Kuku I, et al. An unexpected complication of bone marrow aspiration and trephine biopsy: arteriovenous fistula. Med Princ Pract. 2014;23(4):380–3.

    Article  Google Scholar 

  36. Khakwani M, Srinath S, Pratt G, Moss P. A rare complication of bone marrow aspiration and trephine biopsy: staphylococcus aureus osteomyelitis and septicaemia. Br J Haematol. 2019;184(1):7.

    Article  Google Scholar 

  37. Vadlamudi V, Sterling K (2017) Fluoroscopically guided powered bone marrow biopsy in interventional radiology: a safe and efficacious procedure. Poster presented at: 42nd Annual Scientific Meeting of Society of Interventional Radiology; 2017; Washington, DC

  38. Ellis LD, Jensen WN, Westerman MP. Needle biopsy of bone and marrow; an experience with 1,445 biopsies. Arch Intern Med. 1964;114:213–21.

    Article  CAS  Google Scholar 

  39. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H. World Health Organization classification of tumours of haematopoietic and lymphoid tissues, 4th edn. 2008; International Agency for Research on Cancer, Lyon

  40. Engeset A, Nesheim A, Sokolowski J. Incidence of ‘dry tap’ on bone marrow aspirations in lymphomas and carcinomas. Diagnostic value of the small material in the needle. Scand J Hematol. 1978;22(5):417–22.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, University of Southern California, 1500 San Pablo Street, Los Angeles, CA, 90033, USA

    Anderanik Tomasian

  2. Mallinckrodt Institute of Radiology, 510 South Kingshighway Blvd, St. Louis, MO, 63110, USA

    Jack W. Jennings

Authors
  1. Anderanik Tomasian
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jack W. Jennings
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anderanik Tomasian.

Ethics declarations

Conflict of interest

Jack W. Jennings: Consultation fees from Merit, Stryker, Medtronic, and BTG/Boston Scientific

Anderanik Tomasian: None

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tomasian, A., Jennings, J.W. Bone marrow aspiration and biopsy: techniques and practice implications. Skeletal Radiol 51, 81–88 (2022). https://doi.org/10.1007/s00256-021-03882-w

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-021-03882-w

Keywords

Search

Navigation