What is the specific examination for bone marrow puncture

Bone marrow aspiration is mainly used to examine hematopoietic system diseases, hematological diseases, and some tumor related diseases, by extracting bone marrow fluid to analyze cell morphology, quantity, and pathological changes. The examination contents of bone marrow puncture mainly include hematopoietic function assessment, leukemia diagnosis, anemia etiology analysis, bone marrow fibrosis detection, and tumor metastasis screening.

1. Hematopoietic function assessment

Bone marrow puncture can evaluate the degree and proportion of proliferation of hematopoietic cells in the bone marrow, and determine whether there is excessive or insufficient hematopoietic function. By observing the development of red blood cell lines, granulocyte lines, and megakaryocyte lines, it can assist in the diagnosis of diseases such as aplastic anemia and myelodysplastic syndrome. Abnormal examination results may be accompanied by symptoms such as fatigue and pale skin and mucous membranes, and further diagnosis should be made in conjunction with blood routine.

2. Leukemia Diagnosis

Bone marrow puncture is a key examination for diagnosing leukemia, which can detect an abnormal increase in the proportion of primitive and immature cells. Through cell morphology, immunophenotyping, and chromosome analysis, acute lymphocytic leukemia, acute myeloid leukemia, and other types can be distinguished. The typical manifestation is that leukemia cells account for more than 20% of the bone marrow, often accompanied by symptoms such as fever and bleeding tendency. It is necessary to cooperate with flow cytometry and other examinations to clarify the classification.

3. Analysis of Anemia Causes

For unexplained anemia, bone marrow aspiration can differentiate between iron deficiency anemia, megaloblastic anemia, or hemolytic anemia. Iron deficiency anemia can be characterized by reduced red blood cell volume and delayed cytoplasmic development; Megaloblastic anemia results in the appearance of precursor red blood cells with megaloblastic changes. The examination may reveal abnormal indicators such as decreased serum ferritin or vitamin B12 deficiency, and it is necessary to supplement iron supplements or vitamin B12 treatment according to the cause.

4. Bone marrow fibrosis detection

Bone marrow puncture combined with biopsy can diagnose bone marrow fibrosis, manifested as reticular fibrosis leading to dry pumping phenomenon. Bone marrow pathology shows fibrous tissue replacing normal hematopoietic tissue, often accompanied by splenomegaly and the appearance of immature cells in peripheral blood. Primary myelofibrosis needs to be distinguished from fibrosis secondary to tumors or infections, and JAK2 gene testing can help clarify the diagnosis.

5. Tumor metastasis screening

For patients with solid tumors such as lung cancer and breast cancer, bone marrow aspiration can detect bone marrow metastasis of cancer cells. Clusters of atypical tumor cells can be seen under the microscope, and immunohistochemical staining can determine the primary lesion. Metastatic tumors often present with normal hematopoietic suppression in the bone marrow, which may be accompanied by bone pain and pathological fractures. Imaging examinations such as PET-CT should be combined to evaluate the extent of metastasis. After bone marrow puncture, the puncture site should be kept clean and dry for 24 hours, avoiding vigorous exercise to prevent bleeding. Observe for signs of infection such as fever and persistent pain within 3 days after surgery, and choose a high protein diet to promote recovery. If discomfort symptoms such as dizziness and palpitations occur, seek medical attention promptly. Those who take anticoagulant drugs for a long time should inform their doctor in advance. When the examination results are abnormal, regular blood routine checks should be conducted, and further examinations such as genetic testing or bone marrow biopsy should be carried out in cooperation with doctors.