Bone marrow biopsy results
After the biopsy specimen or aspirate is sent to the lab, results come out:
- To confirm or contradict the diagnosis.
- Stage the disease
- Show response to treatment.
Biopsy results mainly involve the following categories:
- Cellularity: This is a general look on the number of cells in the bone marrow, a hypercellular bone marrow can be an indication of cancer or increased peripheral destruction of blood cells necessitating increased production as in cases of hypersplenism -a condition which involves an enlarged spleen that excessively destroys blood cells-, while a hypocellular bone marrow can be seen in aplastic anemia or bone marrow failure.
- Cellular components: This is a specified view on the bone marrow, and its different cells, the presence of blast cells is normal in the bone marrow as long as they don’t exceed 20%. Otherwise, it is a sure diagnosis of acute leukemia.
- Abnormal components: Some components of a bone marrow biopsy are abnormal, and shouldn’t be there. For example, in hemochromatosis, where excessive iron is deposited in the marrow, or Gaucher and Niemann-Pick diseases, in which excessive fat is found. Another example is amyloidosis, in which excessive amounts of an abnormal protein called amyloid are deposited in the bone marrow.
- Immunophenotyping: This type of investigation is directed towards the identification of the source of malignant cells. Bone marrow cancers as leukemia are known to be monoclonal, which means that they originated from a single mother cell, and proving this relationship is enough to both diagnose cancer and to diagnose this leukemia as myeloid or lymphoid.