What is a bone lesion biopsy?
A bone lesion biopsy is a surgical procedure in which a doctor removes a sample of bone tissue and sends it to a laboratory for analysis. The test generally distinguishes between cancerous and non-cancerous bone tumors and diagnoses other bone abnormalities.
The procedure involves making a small incision, piercing the bone, and removing a tissue sample from the lesion within the bone. An injury is an abnormality in the structure of the bone, which may or may not affect bone growth. Not all lesions are cancerous.
Purpose of bone lesion biopsy
Your physician may order a bone lesion biopsy if there are signs of irregularities in your bones. These may demonstration up on imaging scans, such as X-rays or CT scans. A biopsy helps doctors determine if your bone lesions are the consequence of cancer, infection, or another condition.
Conditions associated with bone tumors or lesions include:
- Coccidiomycosis (fungal infection)
- Ewing’s sarcoma (a cancerous bone tumor that disturbs children)
- Fibroma (benign tumor)
- Histoplasmosis (fungal infection)
- Multiple myeloma (cancer of the bone marrow that distresses plasma cells)
- Mycobacterial infection (tuberculosis)
- Osteoblastoma (kind of bone tumor)
- Osteoid osteoma (benign bone tumor)
- Osteomalacia (unstiffening of the bones due to lack of vitamin D)
- Osteomyelitis (bone infection)
- Osteosarcoma (cancerous bone tumor that usually appears during adolescence)
- Osteitis fibrosa (softening of the bones due to hyperparathyroidism)
- Rickets (weakening of the bones due to deficiency of calcium, vitamin D, or phosphate)
Bone lesion biopsies can also deliver surgeons a classified view of your bones. This is useful when inspecting the status of infections or diseases that could be candidates for amputation, such as osteomyelitis. In some belongings, the biopsy can help prevent the need for an amputation.
How is the test performed?
The test is carried out as follows:
- An X-ray, CT scan, or MRI will likely be used to guide the exact location of the biopsy instrument
- The doctor applies an anesthetic (local anesthetic) to the area
- Then a small cut is made in the skin
- A special piercing needle is often used. This needle is moderately inserted through the cut, then pushed and twisted into the bone.
- Once the taster is obtained, the needle is twisted
- The pressure is useful to the site. Once the bleeding stops, stitches are applied and covered with a bandage.
- The taster is sent to a laboratory for examination
The bone lesion biopsy can also be done under general anesthesia to remove a larger sample. Then, surgery to remove the bone may be done if the biopsy exam shows that there is an abnormal growth or cancer.
How to prepare for the test
Follow your provider’s instructions on how to prepare. This may include not eating or drinking for several hours before the procedure.
What are some of the common uses of the procedure?
Bone biopsies are done to:
- Confirm the diagnosis of a bone disorder
- Investigate an abnormal area, or injury, seen on X-ray, bone scan, CT scan, or MRI
- Distinguish the bone tumor from other conditions, such as an infection
- Differentiate whether a tumor is benign or cancerous
- Regulate the cause of an infection or inflammation
- Identify the cause of bone pain.
What are the benefits and risks of bone lesion biopsy?
Needle biopsy is a reliable method of obtaining tissue samples that can help diagnose whether a lesion is benign (not cancerous) or malignant.
A closed needle biopsy is less invasive than surgical biopsy and can be performed under local anesthesia and moderate (conscious) sedation, whereas surgical biopsy involves a larger incision in the skin and generally requires general anesthesia.
Generally, the procedure is not painful, and the results are as accurate as when a bone sample is surgically removed.
Recovery time is short.
Any procedure where the skin is entered carries a risk of infection. The chance of infection requiring antibiotic treatment seems to be less than one in 1,000.
Complications after a bone biopsy are rare. However, there is a small chance that the biopsy needle will break the bone or injure a nearby nerve, blood vessel, or organ. There is a very small chance that the bone will become infected or weak and not heal properly.
What happens during a bone lesion biopsy?
A bone lesion biopsy can be done on an outpatient basis or as part of your stay in a hospital. Procedures may vary, contingent on your condition and the dose of your healthcare provider.
Also, some biopsies can be done under local anesthesia to numb the area. Others can be done under general or spinal anesthesia. If spinal anesthesia is used, you will not feel from the waist down. Your healthcare provider will deliberate this with you in advance.
Generally, a bone lesion biopsy follows this process:
- You will be asked to eliminate your clothing and will be given a gown to wear.
- An intravenous (IV) line may be placed in your arm or hand.
- It will be positioned so that your healthcare provider can easily reach the bone to be removed. A belt or strap can be used to keep it in the correct position.
- The skin over the biopsy site will be cleaned with an antiseptic solution.
- If a native anesthetic is used, you will feel a needle stick when the anesthetic is injected. This can cause a brief stinging sensation. If general anesthesia is used, you will be put to sleep with an IV medicine.
- If local anesthesia is used to numb the area, you will need to remain still during the procedure.
- The supplier will make a small cut (incision) over the biopsy site. He will insert the biopsy needle into your bone.
- If you are awake, you may feel discomfort or heaviness when your healthcare provider takes the bone sample.
- The biopsy needle will be removed and firm pressure will be applied to the biopsy site for a few minutes, until the bleeding stops.
- Your healthcare provider will close the opening in your skin with stitches or skin sticky strips, if needed.
- A sterile bandage or dressing will be applied.
- The bone sample will be sent to the laboratory for examination.
What happens after a bone lesion biopsy?
Your recovery process will vary, depending on the type of anesthesia you are given. You will be taken to the regaining room for observation. Once your blood pressure, pulse, and breathing are established and you are alert, you will be taken to your hospital room or released home.
Once you are home, it is significant to keep the biopsy area clean and dry. Your healthcare provider will give you specific instructions for bathing. If tacks are used, they will be detached during a follow-up office visit. If adhesive strips are used, they should be kept dry and will generally fall off in a few days.
The biopsy site may be loving or sore for several days after the bone biopsy. Take a pain reliever as optional by your healthcare provider. Aspirin or other pain relievers can increase the chance of bleeding. Be sure to take only recommended medications.
Tell your healthcare provider if you have:
- Fever or chills
- Redness, swelling, bleeding, or other discharge from the biopsy site
- Increased pain around the biopsy site.
You can return to your usual diet and activities unless your healthcare provider tells you otherwise. Your supplier may ask you to avoid strenuous physical activity for a few days.
Your healthcare provider may give you additional or alternative instructions after the procedure, depending on your particular case.
Possible complications of bone lesion biopsy
Side effects of a needle biopsy include:
- Bleeding from the biopsy site
- Damage to nerves or blood vessels
- Bone fracture
Call your doctor if you have blood or fluid leaking from the biopsy site, warmth or swelling of the area, fever, or pain.