Bone Marrow Biopsy Technic: Artifact Induced by Aspiration

Bone marrow aspiration and trephine biopsy specimens are of additive value when assessing various marrow disorders. Many physicians obtain both an aspirate and a trephine core when taking a biopsy of bone marrow, but opinions differ about which biopsy specimen should be obtained first. Some authors mention the possibility of artifactual hypocellularity and hemorrhage in the trephine biopsy specimen when trephine biopsy follows aspiration at the same site. This report describes the occurrence and significance of bone marrow aspiration artifact. The artifact usually occupies a relatively small area of the biopsy specimen and satisfactory evaluation of the marrow is still possible. However, the artifact occasionally hinders marrow evaluation, particularly when the trephine biopsy specimen is relatively short. Because the artifact is not observed in specimens obtained away from the aspiration site, it is best to perform the trephine biopsy before aspiration, or away from the aspiration site, especially when technical problems prevent obtaining a large amount of trephine material.