Advantages and Complications of Bone Marrow Aspiration and Trephine Biopsy

Bone marrow specimens can be examined cytologically and histologically. There are many types of bone marrow examination. I have talked about bone marrow aspiration and trephine biopsy, the two main bone marrow examinations previously. Today, we will discuss about the advantages and complications of bone marrow aspiration and trephine biopsy.

Advantages of Bone Marrow Aspiration

Bone marrow aspirates allow a wider range of cytochemical stains and immunological markers if compare with histological sections. It is good and can be performed well alone for investigating patients with suspected iron deficiency anemia, anemia of chronic disease, megaloblastic anemia, acute leukemia and so on. However, bone marrow aspirates are not equal for demonstration of fine cytological detail.

Advantages of Trephine Biopsy

One of the important features for process of trephine biopsy for diagnosis is when a dry tap or blood tap occurs because of the marrow being fibrotic or densely cellular. Besides, only trephine biopsy permits a complete assessment of bone marrow architecture and the pattern of abnormal infiltrate distribution. It performs well in investigating suspected aplastic or hypoplastic anemia, lymphoma, metastatic carcinoma, myeloproliferative disorders and bone diseases. Furthermore, trephine biopsy is more useful in diagnosing patients with the advanced stages of HIV infection in whom hypocellular if compare with bone marrow aspiration. Yet, trephine biopsy causes more pain than bone marrow aspiration to the patient.

Complications of Bone Marrow Aspiration and Trephine Biopsy

There are many complications of bone marrow aspiration and trephine biopsy although very rare. Cardiac and great vessel laceration are two examples of complications causing by bone marrow aspiration and trephine biopsy. Another example is hemorrhage (bleeding). If hemorrhage occurs, a prolonged firm pressure is necessary after the bone marrow aspiration or trephine biopsy to ensure that bleeding has stopped. If trephine biopsy is worked on bone with an abnormal vasculature, hemorrhage will be the problem. Some of the osteoporosis patients have severe retroperitoneal hemorrhage after bone marrow aspiration and trephine biopsy have been carried out. Sometimes, the lateral cutaneous nerve of the thigh will be damages due to the poor skill. Pneumothoraces can be observed after sterna aspiration and sternomanubrial separation too.

In conclusion, both of these techniques have advantages and limitations respectively. Thus, we can use both techniques as complementary to get the best specimens examination. The complications of these two techniques have to be prevented so that there will be no problem for the patients during examination. If you wish to know more about bone marrow in Cytogenetics Cancer Research blog, you may follow the bone marrow category.

(Reference: Bone Marrow Pathology written by Barbara J. B., David M. C., Irvin A. L. and Bridget S. W.)