Bone lesion biopsy

Definition

A bone lesion biopsy is a test in which a piece of bone or bone marrow is removed for examination.

Alternative Names

Why the Test is Performed

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

How the Test is Performed

A bone lesion biopsy involves removal of a small piece of bone for examination. A special drill needle is usually used. A local anesthetic is given (to numb the area, the patient remains conscious), a small (about 1/8 inch) incision is made in the skin and the biopsy needle is pushed and twisted into the bone.

Once the sample is obtained, the needle is twisted out and the sample is sent for examination. Pressure is applied to the site. Once bleeding stops, the site is cleaned and covered with a bandage.

Bone biopsy may also be performed under general anesthesia for surgical excision (cutting out) of a piece of bone. Excision provides a larger specimen and may permit immediate surgical removal if examination indicates a malignant (cancerous) tumor.

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 moderate 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.

Risks

• Discomfort
• Bone fracture
• Damage to surrounding tissue
• Localized infection (a risk any time the skin is broken)
• Infection of the bone (osteomyelitis)
• Excessive bleeding

Note: Some people with bone disorders also have blood coagulation disorders, so the bleeding risk may be higher.

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.

Normal Results

Normal bone appears as two types: compact and cancellous. Compact bone is dense and contains concentric layers of mineral deposits (lamellae). Cancellous bone looks porous, with widely spaced lamellae, and red and yellow marrow in the center of the bone.

What Abnormal Results Mean

Benign bone tumors include the following:

• Osteoid osteoma
• Osteoblastoma
• Bone cyst
• Fibroma

Malignant tumors include the following:

• Multiple myeloma
• Osteosarcoma
• Ewing's sarcoma

Other conditions include the following:

• Osteomalacia
• Osteitis fibrosa
• Infection (osteitis) associated with:
  • Histoplasmosis
  • Coccidiomycosis
  • Mycobacteria

Additional conditions under which the test may be performed include the following:

• Osteomyelitis
• Rickets