Types Of Biopsies
Bone biopsies differ from bone marrow biopsies because they sample the outside part of the bone rather than the spongy interior that makes up the bone marrow. The basic principles of the biopsy, however, are the same: a small sample of tissue is taken for further examination. Bone biopsies can be performed in one of two ways: needle and open biopsy. With a needle biopsy, a needle is inserted into the skin, which then sucks up a small portion of bone. Open biopsies involve the surgical removal of a piece of bone. Because open biopsies involve general anesthesia and skin incisions, they are generally done if the patient is already undergoing surgery.
Procedure
Needle biopsies are typically done on an outpatient basis. Patients will be given a gown to wear and will be positioned so that the surgeon has easy access to the biopsy site. The area will then be cleaned with an antiseptic solution and numbed using an injection of local anesthesia. A small incision will be made, and then the biopsy needle will be inserted into the bone. After the sample has been obtained, the surgeon will stitch up the incision and apply a bandage or sterile dressing and then send the patient home. The tissue sample will then be sent to a lab for further analysis. Open biopsies are typically done during the course of a surgery, which means the surgeon can directly cut out a small bone sample. Because these types of biopsies are often done during the course of the operation, a pathologist may immediately analyze the biopsy sample and recommend as to whether further surgery is required.
Analysis and Purpose
The analysis of a bone biopsy is done by a trained pathologist who will take the tissue sample and spread it on a glass slide so that it can be examined under a microscope. The pathologist will be looking for any structural abnormalities of the bone cells and matrix as well as for any inflammatory cells or infectious agents that may be present. Bone biopsies can be used to identify the cause of osteomyelitis (an infection of the bone) or to determine the cause of bone tenderness or pain (which can be caused by bone deformities or immune cells attacking the bone). Bone biopsies can also be done to look for abnormal cells that may be causing bone cancer. After the pathologist has thoroughly examined the biopsy, she will write up a formal analysis that will highlight any unusual findings and suggest a diagnosis.
