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Trepanobiopsy is a procedure in which a piece of bone is cut out together with the bone marrow. Trepanobiopsy is performed for diagnostic purposes. It provides a lot of valuable and detailed information about the condition of the patient’s bone marrow. Trepanobiopsy is a more detailed study than a bone marrow biopsy alone.
What is trepanobiopsy and how is it different from bone marrow biopsy?
Bone marrow biopsy is the basic test that is ordered when hematopoietic diseases, including cancer, are suspected. There are two ways to do a bone marrow test. The first is a fine-needle bone marrow biopsy, the so-called aspiration biopsy, which involves the collection of bone marrow cells, most often from the patient’s spinal cord. Fine needle biopsy allows the assessment of individual marrow cells and blood cell precursors. The second way to test the marrow is trepanobiopsja percutaneous, which consists in collecting the entire bone fragment from the patient along with the marrow. For this purpose, a special needle is used to collect a bone fragment, which is then sent to a laboratory for histopathological examination. In this way, it is possible to examine the entire structure of a patient’s bone marrow, not just bone marrow cells. Trepanobiopsja it also allows to evaluate the scaffold in which bone marrow hematopoietic cells are embedded. Trepanobiopsja It is therefore a more accurate examination than a biopsy, it also allows to exclude substance deposits resulting from abnormal metabolism and to diagnose metastases of other neoplasms.
Indications for trepanobiopsy
Fine needle biopsy is performed in patients with suspicion, e.g. acute lymphoblastic and myeloid leukemia, malignant Hodgkin’s and non-Hodgkin’s lymphomas, anemia, thrombocytopenia, toxic bone marrow damage, white blood cell count disorders (e.g. neutrophilia, basophilia, lymphocytosis) and monoclonal immunoglobulin deposition diseases.
Trepanobiopsy is performed when the bone marrow sampling has not been successful (i.e. a so-called dry puncture has occurred). An indication for trepanobiopsy is also the suspicion of diseases in which the marrow infiltration affects not only the hematopoietic cells, but the entire marrow stroma. Trepanobiopsy it is also performed when primary bone marrow fibrosis is suspected and when myelodysplastic syndromes (MDS) are suspected. An indication for trepanobiopsy there are also suspicions of bone marrow metastases in the course of neoplastic diseases and bone marrow invasion by lymphoma. Trepanobiopsy it is also performed in case of suspicion aplasia or bone marrow hypoplasia. This test then allows to assess to what extent the bone marrow has been damaged and to what extent it is still active (produces blood cells).
How is trepanobiopsy done?
For adult patients trepanobiopsy is performed on one of the hip bones. The procedure is performed under local anesthesia. The doctor gives anesthesia at the injection site and disinfects the skin. Then it punctures the iliac bone (iliac spine) with a special needle trepanobiopsji 3-4 cm deep. When the needle reaches the medullary cavity, the doctor removes a special guide located inside the needle and takes the bone marrow, absorbing it into the syringe. Next, the doctor moves the needle properly to remove it together with the bone cylinder, i.e. the fragment of the hip bone containing bone marrow hematopoietic cells. The needle is removed from the patient’s body and a sterile dressing is applied to the puncture site. The doctor removes the bone cylinder along with the marrow cells from the inside of the needle and sends them for histopathological examination.
How to prepare for a trepanobiopsy examination?
Before trepanobiposja no special preparations are necessary. Your doctor may advise you to fast before the test. In the case of patients with bleeding disorders (blood coagulation disorders), consultation with a hematologist and administration of the missing coagulation factor is necessary.
Contraindication to trepanobiopsy there are inflammations of the skin, soft tissues and bones at the injection site – in this case, a different site for the collection of the bone fragment along with the marrow should be selected for examination.
Possible complications after trepanobiopsy surgery
Complications after trepanobiopsy surgery are rare. One of the more serious complications is when the needle breaks while collecting a bone fragment. In rare cases, the needle may separate from the handle. However, this should not happen if trepanobiopsja is carried out by an experienced doctor. Another complication after this procedure may be prolonged bleeding and local inflammatory reactions. In the event of prolonged bleeding, it is sometimes necessary to give the patient blood coagulation factors. Inflammation after trepanobiopsji they are generally not serious and will resolve with appropriate medications.