Category
Hematology
Sub Category
Histology
Synonyms/Aliases
Bone Marrow Biopsy, BM Biopsy.
Abbreviations
N/A
Type
Individual Test
7 Days
Results ready in 7 days.
Method
Tissue processing, staining and microscopy.
Temp
Room temperature.
Setup
Mon-Fri
Components Parameters
N/A. However concurrent CBC/ PBF ordering is required.
Pre-analytic Considerations
N/A
Test Ordering Instructions
Fill out test request form fully & legibly. Clinical history/ indications required inclusive of results of other diagnostic work-up. Concurrent CBC printout or CBC order required. Concurrent PBF order/ examination required for optimal hematological assessment.
Patient preparation
Booking for the procedure is required. Children require sedation/ anaesthesia therefore should be in fasting status at the time of the procedure. Charges for sedation/ anaesthesia are additional.
Sample type
Properly Prepared, Labeled, Air Dried, Fixed Smears Required. Slides Should Be Labeled With 2 Patient Identifiers, Including Name. If Slides Are Not Fixed, Label as Unfixed. If Fixation is done, This Should Be With Freshly Prepared Methanol.
Container/ preservative
Trephine Biopsy should be placed in 10% neutral Buffered Formalin. Additionally if a bone marrow aspirate (BMA) sample is concurrently obtained, BMA slides should be prepared directly. Alternatively, BMA sample can be transferred into EDTA (purple top) Vacutainer but slides must then be prepared within 1-2 hours of collection.
Sample volume
Aim for Trephine Biopsy length ≥15mm.
Rejection criteria
Labeling Issue (Unlabeled/ Mislabeled); Missing Request Form; Mismatch Between Request Form & Sample Details; Missing Age/ Gender; Wrong Sample Type; Insufficient Sample; Broken Slides
Other Instructions
If additional tests are required, obtain the relevant samples & list them on the request form e.g. Flow cytometry (EDTA & heparin Vacutainer, 3ml each), Cytogenetics (Sodium Heparin Vacutainer), Culture (Bood Culture Bottles) etc.
Reference intervals
Negative for disease / Malignancy.
Clinical Utility
Variable E.g. Assess Unexplained Cytopenias (Anemia, Leukopenia, Thrombocytopenia), Unexplained Cytoses (Polycythemia, Leukocytosis, Thrombocytosis), Suspected Malignancy or Infiltration (Leukemia, Lymphoma, Myeloproliferative Neoplasms, Metastatic Disease), Pyrexia of Unknown Origin, Infectious Diseases (E.g. Leishmaniasis), B Symptoms (Unintentional Weight Loss, Drenching Night Sweats, Fever) Etc.
Test Limitations/ Confounders
Poor BMA Slide Preparation & Fixation Can Make BMA Unreportable; Poor Trephine Biopsy Fixation & Decalcification Can Make Biopsies Unreportable.