Bone Marrow Aspiration

Bone marrow aspiration is the removal of a small amount of this tissue in liquid form for examination. The bone marrow biopsy and aspiration procedure provides information about the status of and capability for blood cell production.
A bone marrow aspiration and/or biopsy may be ordered to help evaluate blood cell production, to help diagnose leukemia, to help diagnose a bone marrow disorder, to help diagnose and stage a variety of other types of cancer that may have spread into the marrow, and to help determine whether a severe anemia is due to decreased RBC production, increased loss, abnormal RBC production, and/or to a vitamin or mineral deficiency or excess.

Bone Marrow Procedure

A bone marrow aspiration procedure is a technique used to obtain the blood-forming portion (marrow) of the inner core of bone for examination in the laboratory or for transplantation.
The bone marrow consists of inserting a special needle into a bone that contains marrow and withdrawing the marrow by suction or coring out a sample of the marrow.

- Physical Examination
An exam is much like any doctor’s appointment; the doctor will take a detailed medical history and thoroughly examine the whole body.
- Blood Tests
To diagnose leukemia, a number of blood tests are performed. These tests are used to evaluate the type and quantity of blood cells that are present, the blood chemistry, and other factors.
- Full blood count
It is used to establish the numbers of different blood cell types in the circulation. A low number of red or white blood cells is described as anemia or leukopenia, respectively.
- Bone Marrow Biopsy
A biopsy takes a small sample of bone marrow tissue from the body. The doctor asks the patient to lie on his or her side and nurses clean the biopsy site with iodine or alcohol. After the site is cleaned, the biopsy site is numbed with a local anesthetic. The doctor uses either a very fine needle to draw out only bone marrow tissue, or a thicker needle to take a small sample of bone and bone marrow. The bone marrow sample is examined under a microscope to check for leukemia cells.
- Cytogenetics
It is a newer type of testing for leukemia. Cytogenetic testing uses a sample taken from a blood draw or a bone marrow or lymph node biopsy. The sample’s chromosomes are microscopically examined for abnormalities that indicate damage to the cells’ DNA.
- Spinal tap
The doctor uses a long, thin needle to remove fluid from the lower spine. The procedure takes about 30 minutes and is performed with local anesthesia. You must lie flat for several hours afterward to keep from getting a headache.
- Chest x-ray
An x-ray can show swollen lymph nodes or other signs of disease in your chest.
- CT scan of the head, chest, and belly, to find out whether leukemia has spread there.
- Lumbar puncture is to find out whether leukemia cells are in your cerebrospinal fluid (CSF).
- Differential blood count (DBC)
It is used to determine the relative proportion of blood cell types within the bloodstream. In particular, the percentage of immature leukemic “blast” cells is noted.
- Hematocrit assay
It is used to determine the proportion of the blood that is occupied by erythrocytes (red blood cells). In adult men, normal is about 46% (39.8–52.2) and in adult women, it is about 40.9% (34.9–46.9).

History and Physical Examination

The history and physical examination may reveal the presence of symptoms or signs that are suspicious for lung cancer. Cyanosis, a bluish color of the skin and the mucous membranes due to insufficient oxygen in the blood, suggests compromised function due to chronic disease of the lung.

Chest X-ray

It is used to detect enlarged lymph nodes in the chest or a localized mass in the lungs.

CT Scan

It may be performed on the chest, abdomen, and/or brain to examine for both metastatic and lung tumors. CT scans are X-ray procedures that combine multiple images with the aid of a computer to generate cross-sectional views of the body. A CT scan exposes the patient to a minimal amount of radiation. The most common side effect is an adverse reaction to intravenous contrast material that may have been given prior to the procedure. This may result in itching, a rash, or hives that generally disappear rather quickly.

Magnetic resonance imaging (MRI scan)

is a diagnostic method in which hydrogen ions within the body (and/or specific body parts) are excited by exposure to a magnetic field. The resulting signals are processed by a computer to create an image of the chest to define the location and extent of lung involvement.

Bronchoscopy

It is a visual examination of the windpipe and lung branches performed by a pulmonologist (respiratory disease specialist) using a flexible scope. If the bronchoscopy is still unrevealing, or “negative,” a needle biopsy may be performed.

Needle biopsy

Fine needle aspiration (FNA) uses a slim, hollow needle that is attached to a syringe. The needle is inserted into the suspicious mass and it is pushed back and forth to free some cells, which are aspirated (drawn up) into the syringe and are smeared on a glass slide for analysis.

Bone scan

It may also be performed to rule out suspicions of metastasis to the bones. Metastasis is the process wherein cancerous cells break away from the original tumor, travel, and grow within other body parts.

Positron emission tomography (PET)

It combines the technology of CT scan with the technology of PET (positive emission tomography) scan. PET scans involve injecting a sugar-based radiopharmaceutical, which travels through the body and collects in organs and tissues. The PET scan is used to detect cancer cells in the body and the CT scan provides detailed images that can determine the location and size of the cancer.

Prostate-specific antigen (PSA) test

A test that measures the level of PSA in the blood. PSA is a substance made by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. PSA levels may also be high in men who have an infection or inflammation of the prostate or BPH.

Digital Rectal Exam (DRE)

During this exam, the physician inserts a lubricated, gloved finger (digit) into the rectum. Because of the prostate’s location just in front of the rectum, the physician is able to feel the edge of the prostate where the majority of cancers begin. Abnormalities such as bumps or hardness of the prostate can be detected in this way.

MRI Scan

A magnetic resonance imaging (MRI) scan is a computerized picture made by magnetic fields that can show detailed, cross-sectional images of the inner body. MRI scans can create a clear picture of the prostate gland.

Ultrasound

The prostate can be examined through a type of ultrasound called transrectal ultrasonography. In this exam, a tube is inserted into the rectum that carries the sound waves to the nearby prostate, producing a better image.

CT Scan

A CT (computed tomography) scan is a sophisticated x-ray producedure that uses a computer and rotating x-ray beams to produce images of soft tissue, bone, and blood vessels.

Prostate Biopsy

If an abnormality is found on the DRE or the PSA test, the physician will typically order a biopsy of the prostate.
A biopsy involves taking a very small sample of tissue from the prostate. This is done using a thin needle that is placed into the prostate. A tiny amount of tissue is trapped in the needle while it is in the prostate and then the needle is pulled out. This procedure is usually done by an urologist or other surgeon. The pathologist will examine the biopsy sample to check for cancer cells and determine the Gleason score. The Gleason score ranges from 2-10 and describes how likely it is that a tumor will spread. The lower the number, the less likely the tumor is to spread.
There are 2 types of biopsy procedures used to diagnose prostate cancer:
- Transrectal biopsy : The removal of tissue from the prostate by inserting a thin needle through the rectum and into the prostate.
- Transperineal biopsy: The removal of tissue from the prostate by inserting a thin needle through the skin between the scrotum and rectum and into the prostate.

Needle Biopsy

During a needle biopsy, the surgeon makes a small hole in the bone and removes a sample of tissue from the tumor with a needle-like instrument. There are 2 types of needle biopsies: fine needle biopsies and core needle biopsies. In Fine Needle Biopsy, the tissue sample is removed with a thin needle attached to a syringe. In Core Needle Biopsy, the doctor removes a small cylinder of tissue sample from the tumor with a rotating knife like device.

Surgical bone biopsy

In this procedure, a surgeon needs to cut through the skin to reach the tumor in order to remove a small piece of tissue. This is also called an incisional biopsy. If the entire tumor is removed (not just a small piece), it is called an excisional biopsy. These biopsies are often done under general anesthesia (with the patient asleep). They can also be done using a nerve block, which makes a large area numb.

Cone Biopsy

A cone-shaped piece of tissue is removed. The cone biopsy is also a treatment, and can completely remove many precancers and early cancers. More than 90 percent of cervical cancers can be halted with this technique without further treatment. Tissue is removed from the area between the ectocervix and the endocervix. It includes two methods :
- LEEP : A loop electro surgical excision procedure (LEEP) is a procedure done under local anesthesia to remove tissue from the cervix. A LEEP uses an electrically charged wire loop to remove a tissue sample.
- Cold knife cone biopsy : The physician uses a surgical scalpel or laser (intense, focused light beam) to remove abnormal cervical tissue. It is done under general anesthesia.

Colposcopy

The colposcope combines a bright light with a magnifying lens to make tissue easier to see. It is not inserted into the vagina. A colposcopy is usually done in the doctor’s office or clinic. If colposcopy reveals abnormal areas on the cervix, the physician will order a biopsy.

Endocervical Curretage

After the anasthesia is given, a narrow instrument called a curette is inserted into the endocervix and cells are taken.

Dilation And Curettage (D&C)

During a “D&C,” the physician enlarges the cervix (dilation) and scrapes the inside of the uterus and cervical canal (curettage) to remove tissue for microscopic analysis.

Cervicography

It examines a photographic image of the cervix. Cervicography may clarify abnormal Pap test results in women.

Self Breast Exam

Changes in the breast can occur because of aging, your menstrual cycle, pregnancy, menopause, or taking birth control pills or other hormones. Breast self-exams cannot replace regular screening mammograms and clinical breast exams.

Mammographic Screening

The first diagnostic tool to identify breast cancer is Mammogram. It is an X-ray of the breast that can show the presence of abnormal growth lumps in the breast area.

Ultra-Sonography

Use of high frequency sound waves often identifies whether the lump is filled with liquid or solid for further investigation.

Clinical Breast Exam

During a clinical breast exam, your health care provider checks your breasts. You may be asked to raise your arms over your head, let them hang by your sides, or press your hands against your hips. The skin of your breasts is checked for a rash, dimpling, or other abnormal signs. Your nipples may be squeezed to check for fluid. A thorough clinical check up takes about 10 min.

Aspiration

Fine needle is inserted in the lump to take the tissue or liquid out from the lump and then a biopsy is performed to test for carcinoma.

Surgical Biopsy

Surgical biopsy removes a small part of lump by surgery and then the lump is tested for further diagnosis.