Description

A bone marrow trephine (core) biopsy should be performed when there are clear indications. Although low risk it can have serious complications and may be uncomfortable for the patient.


Initial workup:

(1) focal bone lesion of unknown cause

(2) pancytopenia or unexplained anemia, leucopenia, or thrombocytopenia

(3) unexplained leucoerythroblastic blood film or suspicion of marrow fibrosis

(4) fever of unknown origin (FUO) or disseminated granulomatous disease

(5) inadequate or failed bone marrow aspirate

 

Diagnosis and therapeutic followup:

(1) aplastic or hypoplastic anemia

(2) myelodysplastic syndrome

(3) myeloproliferative disorders

(4) acute or chronic myeloid leukemia

(5) acute or chronic lymphocytic leukemia, including hairy cell leukemia

(6) Hodgkin’s disease

(7) non-Hodgkin’s lymphoma, including staging

(8) plasma cell dyscrasia including multiple myeloma

(9) primary amyloidosis

(10) mast cell disorder

(11) metastatic carcinoma

(12) small cell tumours of childhood

(13) metabolic bone disease


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