Your doctor will go through the procedure with you but this. Mean time between receipt of a trephine biopsy specimen and issuance of a histopathological report was 9 days. Comparison of the diagnostic value of bone marrow biopsy and bone marrow aspiration in neoplastic disease. Bone marrow aspiration bma and trephine biopsy are indispensable diagnostic tools for evaluating hematological and. Bone marrow biopsy an overview sciencedirect topics. The proliferation and accumulation of blast cells in the marrow.
Another variation to this procedure is the trephine osteotomy genial bone advancement trephine gbat system stryker leibinger inc. Trephine biopsies of the bone marrow should be carried out, when clinically indicated, by trained individuals following a standard operating procedure. The procedure should be explained in detail to the patient. Although 40% of trephine biopsies yielded information that could not be reliably obtained from a bone marrow aspirate such information was in all cases. A combined report would merge all the information in tables 3 and 4, and thus provide a comprehensive. The bone marrow trephine biopsy lab test is used to measure the level of bone marrow in the patients body. Bone marrow aspiration was done in 166 cases and trephine biopsy in 87 cases in the department of pathology, jipmer pondicherry.
Trephines can be used in a variety of procedures and settings, most commonly appearing in the operating room, where they are used in controlled circumstances to gain access to an area of the body, take a sample for biopsy, or as part of another type of surgical procedure. The routine study of bone marrow trephine biopsies involves fixation, decalcification, paraffin embedment, sectioning and staining. Insert the biopsy needle into the bone obtain a core of tissue using a toandfro rotation main problems. Ackermann vertebral trephine biopsy instruments 2 sheetssheet 1 filed feb. Serum lactate dehydrogenase level in acute leukemias. Interpretation of bone marrow trephine biopsies in hematological disorders with special emphasis on morphological patterns in lymphomas article pdf available january 2015 with 1,494 reads. Trephine definition of trephine by medical dictionary. Bone marrow biopsy is often performed in tandem to provide information about the marrow an.
If the aspirate is performed with a trephine needle, the aspirate sample may be haemodiluted. Bone marrow trephine biopsy test test results, normal. If the trephine biopsy is performed first, the aspirate needle should be positioned on the bone surface approximately 0. The bone marrow samples are sent to a laboratory for examination under a microscope and further testing. The aspirate and trephine biopsy specimens are com. If you dont have an id band we will also ask you to confirm your address. The test is performed in order to confirm disorders of bone marrow due to diseases like anemia, leukemia, lymphoma. Trephine system 2 ao principles 3 approach 4 extract 7 insert implant 8 instruments 10 set list 12 synthes spine warnings. Trephine biopsy definition of trephine biopsy by medical. Mutaz fawzi impaired production of normal blood cells.
Bone marrow trephine biopsy request pdf researchgate. About 10 000 bmt specimens have been analysed using this procedure since 1997 and diseases involving the bone marrow have been classified successfully. Bone marrow trephine biopsy plays a major role in the diagnosis of underlying causes, in. The best site for bone marrow biopsy is the posterior superior iliac spine.
A case of pancytopenia and reticulocytopenia with multiple. Introduction bone marrow aspiration aspiration is aspirate of the contents of bone marrow drawn under pressure by puncturing marrow cavity. Bone marrow trephine biopsy is an integral component of the diagnosis, staging and follow. How reliable is histologic examination off bone marrow trephine. Ajcc cancer staging manual, 7th edition, american joint committee on cancer. Complications are uncommon and include soft issue trauma, haemorrhage and. Cheng biopsy trephine system cannulated thandle and trephines allow use of a standard 1. Bone marrow aspirate and trephine bmat biopsy is a commonly performed procedure in hematologyoncology practice.
One of the most important drawbacks of jamshidi trephine biopsy needles without any core retention device is the fact that as the biopsy needle is being withdrawn from the patients body, the biopsy specimen contained within the lumen of the needle sometimes start to slip out of the needle as illustrated in figures 46. It is recommended that the aspirate and trephine biopsy be obtained using the respective needles separately, and not through a trephine needle. The trephine specimen is obtained by inserting the biopsy needle into the bone and using a toandfro rotation to obtain a core of tissue. Pdf interpretation of bone marrow trephine biopsies in. Bone marrow trephine biopsy journal of clinical pathology. Bone marrow smear the differential practical advices always do your differential with 1,000x magnification. Trephine biopsy sections should be examined and reported in a systematic manner, assessment being made of the bones, the vessels and.
The correlation between aspirates and trephine biopsies was highest in cases of small cell carcinoma of the lung 311, or 36. Bone marrow aspiration is performed to assess cellular morphology and to conduct tests on the bone marrow. The bone marrow aspirate and biopsy in the diagnosis of unsuspected nonhematologic malignancy. Bone marrow trephine biopsy is essential in the initial staging of certain paediatric tumours, such as neuroblastoma, rhabdomyosarcoma, primitive neuroectodermal tumour, and ewings tumour. Bone marrow examination is used in the diagnosis of a number of conditions, including leukemia, multiple myeloma, lymphoma, anemia, and pancytopenia. When there is abnormal finding in routine blood film, bone marrow evaluation become important to know the exact cause. Icsh guidelines for the standardization of bone marrow. Pdf an unexpected complication of bone marrow aspiration. Count at least 200300 nucleated cells between 4060 cells can be counted in one field with oil immersion. This system must not be applied to a vertebral body in which pedicle screws will be placed. Specimens of bone marrow trephine biopsy bmt are transported and fixed in acetic acidzincformalin fixative, decalcified in 10% formic acid5% formaldehyde and processed with other specimens to paraffinwax embedding.
To compare the diagnostic value of bone marrow aspiration and biopsy. There is no absolute contraindication to combining aspiration and trephine biopsy. Practical guide to bone marrow sampling for suspected. Adequate size and integrity of the initial specimen are crucial, although data defining what constitutes an adequate sample in. Peripheral blood aspirate smeartouch preparations core biopsy the three hematopoietic lineages are myeloids, erythroids, and megakaryocytes knowledge of normal marrow morphology, distribution, and maturational sequence is. Consultant hematologist, aga khan university hospital, pakistan. However, for a variety of reasons, the pathologist may receive the core biopsy and aspirate clot section without all of this information. Frozen bone marrow trephine biopsy a technical evaluation sk cheong mbbs, frcp and yc lim dlpmlt l division of haematology, faculty of medicine, national university of malaysia, kuala lumpur. Bone marrow samples are usually taken from the back of the pelvic bone the bony part. An unexpected complication of bone marrow aspiration and trephine biopsy. The main problems with this method are that the specimen may be crushed, thereby distorting the architecture, and it is difficult to. Detection was also increased by serial sectioning of the biopsy specimens. Clinicopathological study of adult pancytopenia with. Bone marrow trephine biopsy changes following chemotherapy andor bone marrow transplantation.
In general, a bone marrow study is composed of the following complementary components. Department of pathology and laboratory medicine, aga khan university hospital, pakistan. Serum lactate dehydrogenase level in acute leukemias dr. While the needle is inside the bone, small pieces of bone and marrow are also removed. If we dont ask these questions, then please ask us to check. Bone marrow examination is a useful and cost ef fective diagnostic procedure in haematological practice for the diagnosis of both neoplastic. All the aspirate smears were routinely stained by jenner giemsa while the. A trephine is a type of medical instrument which is designed to be used to remove circular crosssections of material. A core of intact marrow is withdrawn, usually 1 to 2 cm in length, which is ideally suited to provide information of an architectural or topographic nature rather than providing the. The detection of bone marrow infiltration in the initial staging bone marrow biopsy means that trephine biopsy is also required during follow up. A sample of the patients bone marrow is used to conduct the test. Although 40% of trephine biopsies yielded information that could not be reliably obtained from a bone marrow aspirate such information was in all cases clinically irrelevant or obtainable by non.
Reticulocytopenia with multiple granulomas on bone trephine biopsy. The trephine system should not be used on patients who suffer from osteoporosis or any condition which may result. Sanjeev kumar bsc mlt 1 department of haematology 2. The biopsy is usually performed using a jamshidi size 811 needle. Specimens of bone marrow trephine biopsy bmt are transported and fixed in acetic acidzincformalin fixative, decalcified in 10% formic acid5% formaldehyde and processed with other specimens to paraffin. The biopsy can be collected from several different sites anterior or. Practical guide to bone marrow sampling for suspected myelodysplastic syndromes.
According to the party, soft tissue biopsy devices cannot be used in bone marrow biopsy procedures. The usual site for a bmat is the posterior or anterior iliac crest. Role of bone marrow trephine biopsy in the diagnosis of marrow involvement in hodgkins disease. Comparison of relative value of bone marrow aspirates and. Bone marrow examination refers to the pathologic analysis of samples of bone marrow obtained by bone marrow biopsy often called trephine biopsy and bone marrow aspiration. Making the most of bone marrow trephine biopsy wilkins. Although complications are uncommon, they can cause significant morbidity and mortality.
Pdf bone marrow aspiration and biopsy researchgate. The first step is to identify the parts of the needle, and then locate the sampling site. This was a prospective study carried out to identify the causes of pancytopenia based on bone marrow examination. To remove a disc of bone or other tissue by means of a trephine. The all, is a neoplastic disease that results from somatic mutation in a single lymphoid progenitor cell at one of several discrete stages of development. Audit of bone marrow aspirates and trephine biopsies in. With this technique, the operator places a circular guide on the buccal bone overlying the genial tubercle location, and a. The trephine biopsy of the bone marrow is usually a complementary diagnostic technique rather than a primary investigative one. Diagnostic role of bone marrow aspiration and trephine biopsy in haematological practice taj ali khan1, irfan ali khan2, khalid mahmood3 introduction bone marrow examination is a useful and cost effective diagnostic procedure in haematological practice for the diagnosis of both neoplastic and nonneoplastic haematological diseases. Bone marrow aspiration and trephine biopsy bmat is a procedure performed for the diagnosis and staging of haematological disorders. Icsh guidelines for the standardization of bone marrow specimens. Simulation models are an excellent tool to teach novice doctors basic procedural skills before performing the actual procedure on patients to. A total of 88cases with both bone marrow aspiration and biopsy were included in the study.
225 1455 1292 383 511 870 1130 1221 1074 172 7 772 46 1377 69 31 1076 286 352 188 175 684 323 1444 1340 924 769 632 937 1375 106 769 1080 436 703