骨髓活检

定义

骨髓 活组织检查 is the removal of marrow from inside bone. Bone marrow is the soft tissue inside bones that helps form blood cells. It is found in the hollow part of most bones.

骨髓活检 is not the same as 骨髓抽吸. An aspiration removes a small amount of marrow in liquid form for examination.

选择的名字

活组织检查-骨髓

如何执行测试

骨髓 活组织检查 may be done in the health care provider's office or in a hospital. The sample may be taken from the pelvic or breast bone. 有时，使用另一个区域.

Marrow is removed in the following steps:

• If needed, you are given medicine to help you relax.
• The provider cleans the skin and injects numbing medicine into the area and surface of the bone.
• A 活组织检查 needle is inserted into the bone. The center of the needle is removed and the hollowed needle is moved deeper into the bone. This captures a tiny sample, or core, of bone marrow within the needle.
• The sample and needle are removed.
• Pressure and then a bandage are applied to the skin.

A 骨髓抽吸 may also be done, usually before the 活组织检查 is taken. 皮肤麻木后, the needle is inserted into the bone, and a syringe is used to withdraw the liquid bone marrow. If this is done, the needle will be removed and repositioned. Or, another needle may be used for the 活组织检查.

如何准备考试

告诉供应商:

• If you are allergic to any medicines
• 你在吃什么药啊
• 如果你有出血问题
• 如果你怀孕了

考试的感觉如何

You will feel a sharp sting when the numbing medicine is injected. The 活组织检查 needle may also cause a brief, usually dull, pain. Since the inside of the bone cannot be numbed, this test may cause some discomfort.

If a 骨髓抽吸 is also done, 你可能会觉得很短暂, sharp pain as the bone marrow liquid is removed.

为什么要进行测试

Your provider may order this test if you have abnormal types or numbers of red or white blood cells or platelets on a 全血计数 (CBC).

该测试用于诊断:

• 贫血(某些类型)
• 感染
• 白血病
• Other blood cancers and disorders

It may also be used to help determine if a cancer has spread or responded to treatment.

正常的结果

A normal result means the bone marrow contains the proper number and types of blood-forming (hematopoietic) cells, 脂肪细胞, 结缔组织.

异常结果意味着什么

Abnormal results may be due to cancers of the bone marrow (leukemia, 淋巴瘤, 多发性骨髓瘤, 或其他癌症).

The results may detect the cause of anemia (too few red blood cells), abnormal white blood cells, or 血小板减少症 (血小板太少).

Specific conditions for which the test may be performed:

• A body-wide fungal infection (for example, 播散性球孢子菌病)
• A white blood cell cancer called 毛细胞白血病
• 淋巴组织癌(何杰金氏病 or 非霍奇金淋巴瘤)
• Bone marrow doesn't make enough blood cells (再生障碍性贫血)
• 血癌称为 多发性骨髓瘤
• Group of disorders in which not enough healthy blood cells are made (myelodysplastic syndrome; MDS)
• 一种神经组织肿瘤叫做 神经母细胞瘤
• Bone marrow disease that leads to an abnormal increase in blood cells (真性红细胞增多)
• Abnormal protein buildup in tissues and organs (淀粉样变)
• Bone marrow disorder in which the marrow is replaced by fibrous scar tissue (骨髓纤维化)
• Bone marrow produces too many platelets (血小板增多)
• 叫做白细胞癌 Waldenstrom巨球蛋白血
• Unexplained anemia, 血小板减少症 (low platelet count) or leukopenia (low WBC count)

风险

There may be some bleeding at the puncture site. More serious risks, such as serious bleeding or infection, are very rare.

参考文献

贝茨一世，伯瑟姆一世. 骨髓活检. In: Bain BJ, Bates I, Laffan MA, eds. Dacie and Lewis Practical Haematology. 12日艾德. Philadelphia, PA: Elsevier; 2017:chap 7.

陈国强，张国强. Bone marrow aspiration analysis-specimen (活组织检查, bone marrow iron stain, iron stain, bone marrow). 见:陈国强，张国强编. Laboratory Tests and Diagnostic Procedures. 6日艾德. St Louis, MO: Elsevier Saunders; 2013:241-244.

Choby英航. Bone marrow aspiration and 活组织检查. 见:福勒GC编. Pfenninger and Fowler's Procedures for 初级护理. 第四版. Philadelphia, PA: Elsevier; 2020:chap 220.

瓦杰帕伊N，格雷厄姆SS，本S. Basic examination of blood and bone marrow. 见:McPherson RA, Pincus MR，编辑. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24日艾德. Philadelphia, PA: Elsevier; 2022:chap 31.