1.assig-Bma New-1
1.assig-Bma New-1
1.assig-Bma New-1
ON
BONE MARROW
ASPIRATION
DEFINITION
PURPOSES
Examination of the bone marrow may be the next step that follows an
abnormal clinical finding, such as an abnormal complete blood count
(CBC), and/or an abnormal peripheral blood smear.
It may also be performed following an abnormal bone image such as the
finding of a lesion on x rays.
A biopsy of bone marrow shows the intact tissue, so that the structure of the
fat cells, lymphocytes, plasma cells, fibrous connective tissue cells, and
other cells, and their relationships to each other, can be seen.
INDICATIONS
To evaluate the unusual peripheral blood finding, thrombocytopenia,
unexplained anemia, and pancytopenia.
To investigate hypoplastic anemia, malignant hematological disorders,
metastatic expansion of tumours, and congenital bone marrow deficiency
syndrome
To achieve the cultures of bone marrow especially in case of infection of
unknown origin.
For evaluation of abdominal masses, lymphadenopathy, and hypersplenism.
To follow up the chemotherapy or transplantation of hematopoietic stem
cells
Clinical Indication - Bone Marrow Biopsy:
Contraindications
DIAGNOSIS/PREPARATION
Adults require no special preparation for this test. As for infants and
children, they need physical and psychological preparation depending on
the child's age, previous medical experiences, and level of trust.
Infant preparation
Before the test, parents should know that their child will most probably
cry, and that restraints may be used.
To provide comfort, and help their child through this procedure, parents
are commonly asked to be present during the procedure. Crying is a
normal infant response to an unfamiliar environment, strangers,
restraints, and separation from the parent.
Infants cry more for these reasons than because they hurt.
Preschooler preparation
AFTERCARE
1. After the needle is removed, the biopsy site is covered with a clean, dry
pressure bandage.
2. The patient must remain lying down and is observed for bleeding for one
hour. The patient's pulse, breathing, blood pressure, and temperature are
monitored until they return to normal.
3. The biopsy site should be kept covered and dry for several hours.
4. The patient should be able to leave the clinic and resume most normal
activities immediately.
5. Patients who have received a sedative often feel sleepy for the rest of the
day; so driving, cooking, and other activities that require clear thinking
and quick reactions should be avoided.
6. Walking or prescribed pain medications usually ease any discomfort felt
at the biopsy site, and ice can be used to reduce swelling.
A doctor should be notified if the patient:
Feels severe pain for more than 24 hours after the procedure
Experiences persistent bleeding or notices more than a few drops of
blood on the wound dressing
Has a temperature above 101°f (38.3°c)
Inflammation and pus at the biopsy site and other signs of infection
Risks
NORMAL RESULTS
Healthy adult bone marrow contains yellow fat cells, connective tissue,
and red marrow that produces blood.
Bone marrow is evaluated for cellularity, megakaryocyte production, M:E
ratio, differential (classification of blood forming cells), iron content,
lymphoid, bone, and connective tissue cells, and bone and blood vessel
abnormalities.
The bone marrow of a healthy infant is primarily red (75–100%
cellularity), but the distribution of blood forming cells is very different
than adult marrow. Consequently, age-related normal values must be used.
Microscopic examination of bone marrow can reveal leukemia,
granulomas, myelofibrosis, myeloma, lymphoma, or metastatic cancers,
bone marrow infection, and bone disease.
BIBLIOGRAPHY
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