Indications for histobiopsy (myelotomy) of marrow-containing bone
The question of the indication for histological examination of marrow-containing bone in the clinic may be answered from two points of view: On the one hand, an expected diagnostic and scientific benefit in already advanced diagnostic analysis and on the other, certain clinical findings arousing suspicion of existing bone or bone marrow disease independent of such an analysis, which can only be elucidated by histological methods. This separation is mainly of theoretic importance, more frequently arguments for the two aspects obtain. Examples of the first case are: The question of type and extent of an already recognized haemoblastic process as guiding principle for the initiation and later effective control of treatment or the confirmation of a suspected diagnosis of hyperparathyroidism. The second case was demonstrated by a female patient with granulocytopenia, thrombopenia and moderately increased sedimentation rate for 2 months, and no other relative signs or symptoms, where myelofibrosis was found on marrow histology; or in cases of refractory rheumatic complaints with uncharacteristic humoral and roentgenological findings whose histological basis might have been osteomalacia, osteoporosis, hyperparathyroidism or carcinomatosis of the bone marrow.