Bone marrow has a fluid portion and a more solid portion. In bone marrow aspiration, your doctor uses a needle to withdraw a sample of the fluid portion. In a bone marrow biopsy, a larger needle is used to take a sample of the solid part.
Bone marrow biopsy and bone marrow aspiration are often done at the same time. Together, bone marrow biopsy and aspiration may be called a bone marrow exam.
Bone marrow biopsy and bone marrow aspiration offer detailed information about the condition of your bone marrow and blood cells. Your doctor may order a bone marrow exam if blood tests, such as cell counts, are abnormal or don't provide enough information about a suspected problem. Examining bone marrow gives a detailed picture of the types, amount and condition of forming blood cells.
Your doctor may perform a bone marrow exam to:
- Diagnose a disease or condition involving the bone marrow or blood cells
- Determine the stage or progression of a disease
- Check iron levels and metabolism
- Monitor treatment of a disease
- Anemia
- Bone marrow disorders, such as myelodysplastic syndrome and myelofibrosis
- Blood cell conditions in which too few or too many of certain types of blood cells are produced, such as leukopenia, leukocytosis, thrombocytopenia, thrombocytosis, pancytopenia and polycythemia
- Cancers of the blood or bone marrow, including leukemias, lymphomas and multiple myeloma
- Cancers that have spread from another area, such as breast, into the bone marrow
- Hemochromatosis
- Infections

Source : www.mayoclinic.org

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