Several factors affect the 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.

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