Adequacy of a Bone Marrow Biopsy in a Pediatric Patient

A bone marrow is adequate if:

(1) diagnoses can be made

(2) all relevant testing can be completed

An inadequate bone marrow biopsy may:

(1) be crushed or otherwise too distorted to interpret

(2) contain excessive cortical bone

(3) miss a target lesion

(4) consist mostly of blood

(5) not contain a representative sampling of hematopoietic tissue

The recommended length for a biopsy core should be >= 1 cm in length.

A core < 0.5 cm has a high rate of inadequacy.

Since a core may break during handling, total length needs to be considered as well.

A blood clot in the shape of a core should not be counted.

Since the core shrinks during processing, the assessment should be based on the original length.