Finding the right tests…
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Finding the right tests…
Haematology
Bone marrow examination looks at the liquid part of the marrow - a small amount of fluid and cells drawn out with a fine needle and syringe, then smeared thinly onto slides, much like a blood film. Because the cells stay separated rather than trapped in solid bone, a pathologist can study individual cell shape, size and maturity under high magnification, which is harder to judge on a solid tissue core. This aspirate step is usually done first, through the same needle entry point at the back of the hip, before the biopsy needle goes in for a tissue core. It is the step that counts how many of each blood cell type the marrow is actually making.
The result is a differential count and description of the marrow's individual cells - the proportion of each stage of red cell, white cell and platelet-forming cell present, and whether any look abnormal or immature in a way that should not be there. Special stains can be added to the smear to test for iron stores or specific enzyme markers. Because the sample is fluid, it can also be sent for additional tests like chromosome analysis or flow cytometry from the same draw.
Individual cells spread thinly on a slide can be studied one by one - their nucleus shape, how mature they look, whether they are dividing normally. This level of cell-by-cell detail is what lets a pathologist recognise leukemia cells or abnormal maturation patterns that a solid tissue section, viewed as a block, does not show as clearly.
If the marrow is scarred or packed too densely with cells, the needle can come back with little or no fluid - a dry tap - and the biopsy core becomes the main source of information instead. This is one reason the two tests are usually done together rather than as alternatives.
- Counting the proportion of each blood cell type being produced - Looking for leukemia cells or abnormal cell maturation - Sending part of the sample for chromosome or flow cytometry testing - Checking iron stores in the marrow with a special stain
Turnaround depends on which additional stains or tests are needed alongside the basic smear reading. Ask your doctor or the centre for a realistic timeline for your case.
This test draws liquid marrow and cells for a smear that shows individual cell detail. A biopsy removes a solid tissue core instead, which shows the marrow's overall structure. Both are usually done at the same visit for a complete picture.
Each shows something the other cannot - individual cell detail from the aspirate, and tissue architecture from the biopsy core. Doing both from the same site avoids a second procedure later.
This is called a dry tap and happens when the marrow is scarred or overly dense with cells. When it occurs, the biopsy core becomes the main source of diagnostic information.
The skin is numbed first, but most people feel brief pressure or a pulling sensation as the fluid is drawn out. It is typically quick, lasting only a few minutes.
This page is general information about the test, not medical advice. Your own report's reference ranges apply — please discuss your results with your doctor.
Yes. Part of the fluid sample can be sent for chromosome analysis or flow cytometry when your doctor needs that additional information, without a separate procedure.
It depends on how many additional stains or tests are ordered alongside the basic smear. Ask your doctor or the centre for an expected timeline for your report.