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Bone lesion biopsy

Bone biopsy; Biopsy - bone

 

A bone lesion biopsy is the removal of a piece of bone or bone marrow for examination.

How the Test is Performed

 

The test is done in the following way:

  • The health care provider applies a numbing medicine (local anesthetic) to the area. A small cut is then made in the skin.
  • A special drill needle is usually used. This needle is gently pushed and twisted into the bone.
  • Once the sample is obtained, the needle is twisted out.
  • Pressure is applied to the site. Once bleeding stops, stitches are applied, and covered with a bandage.
  • The sample is sent to a lab for examination.

Bone biopsy may also be done under general anesthesia to remove a larger sample. Then surgery to remove the bone can be done if the biopsy exam shows that there is an abnormal growth or cancer.

 

How to Prepare for the Test

 

You may be told not to drink or eat anything for several hours before the biopsy.

 

How the Test will Feel

 

With a needle biopsy, you may feel some discomfort and pressure, even though a local anesthetic is used. You must remain still during the procedure.

After the biopsy, the area may be sore or tender for several days.

 

Why the Test is Performed

 

The most common reasons for bone lesion biopsy are to tell the difference between cancerous and noncancerous bone tumors and to identify other bone problems. It may be performed on people with bone pain and tenderness, particularly if x-ray, CT scan, or other testing reveals a problem.

 

Normal Results

 

Normal bone appears as two types: compact and cancellous.

  • Compact bone is dense and contains layers of mineral deposits called lamellae.
  • Cancellous bone looks porous or spongy, with widely spaced mineral deposits, and red and yellow marrow in the center of the bone.

 

What Abnormal Results Mean

 

Benign (noncancerous) bone tumors include:

  • Bone cyst
  • Fibroma
  • Osteoblastoma
  • Osteoid osteoma

Cancerous tumors include:

  • Ewing sarcoma
  • Multiple myeloma
  • Osteosarcoma
  • Other types of cancer that may have spread to the bone

Abnormal results may also be due to:

  • Infections such as coccidiomycosis, histoplasmosis, and mycobacteria infection
  • Osteitis fibrosa
  • Osteomalacia
  • Osteomyelitis
  • Rickets

 

Risks

 

  • Bone fracture
  • Bone infection (osteomyelitis)
  • Damage to surrounding tissue
  • Discomfort
  • Excessive bleeding
  • Infection near the biopsy area

Some people with bone disorders also have blood clotting disorders, which can increase the risk for bleeding.

 

Considerations

 

Signs of bone infection (one of the most serious risks) include fever, headache, pain with movement, redness and swelling of the tissues around the biopsy site, and drainage of pus from the biopsy site. If these occur, seek immediate medical attention.

 

 

References

Matteson EL, Osmon DR. Infections of the bursae, joints, and bones. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 280.

Schwartz HS, Holt GE. Bone tumors. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 34.

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        Review Date: 9/8/2014

        Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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