Perth Haematology :: Dr Steven Ward
Bone Marrow Examination
Bone marrow examination is the test performed by Haematologists to obtain a sample of marrow to study the cells within the marrow. It is a very important test, often yielding the answer to the cause of the blood problem (i.e. providing the diagnosis).
The procedure is relatively straight-forward. The whole process takes 5-15 minutes. There is some discomfort but nothing severe. Two samples are usually taken from the back of pelvic bone using local anaesthetic.
Marrow Aspirate: obtaining marrow cells (liquid) for spreading onto slides and examination by microscope. This is almost always the most important part. The various marrow cell numbers and appearance (morphology) is assessed in detail.
Marrow Trephine: the core sample containing bone and marrow cells. This sample is useful as it preserves the normal marrow architecture so cells are positioned as they are within the marrow, also all cells are usually obtained (the aspirate can occasionally fail to obtain cells due to scarring or other difficulties). The trephine is useful in determining the pattern of disease involvement.
Additional tests performed on marrow: Often extra tests are required to confirm or aid the diagnosis. These are Immunophenotpying (or flow cytometry) to assess the immunological characteristics of the various cells; Cytogenetics (including FISH) invloves preparing chromosomes from the marrow cells to identify any abnormalities. Microbiological culture of marrow is occasionally useful (eg in diagnosis of Mycobacterial infections, TB).