Figure 1: The trocar was left in place after two attempts at bone marrow biopsy. Median sternotomy was performed without removing the trocar. The aorta was repaired off-pump, by placing a purse-string suture around the biopsy needle. Figure 2: CT shows injury of the anterior wall of the ascending aorta by the biopsy trocar. The patient was immediately transferred to a regional centre with cardi...

We report the case of an elderly woman with polycythemia vera submitted to bone marrow biopsy who developed retroperitoneal hemorrhage as a result of direct penetration of the needle through the iliac crest, with damage to the iliolumbar artery, the first branch of the hypogastric artery.

The second quarter of 2009 saw steady advances in bone marrow biopsy (BMB) pathology. The following publications are a personal selection of the highlights. Quality issues in diagnostic immunohistochemistry for BMB have largely been ignored in external quality assurance programmes, and this issue is highlighted. In other areas, publications reflecting advances in flow cytometry and aspirate mor...

Fifty patients were randomised in a double blind placebo controlled study to examine the influence of lorazepam (4 mg orally) before bone marrow aspiration and trephine biopsy. Assessment was made by a visual analogue linear pain scale compiled after the procedure and again 24 hours later. There was no difference in the pain recalled immediately after the procedure between the two groups, but t...

BACKGROUND Although some hazards are recognised, in general, bone marrow aspiration and trephine biopsy are thought to be safe procedures. Until recently, no attempt had been made to quantify any attendant risks. For this reason, documentation of adverse events was begun in 2001, under the auspices of the British Society for Haematology. Three consecutive years have now been surveyed, the resul...

A 72-year-old man with a history of high-grade urothelial carcinoma presented for evaluation of suspected multiple myeloma. He had a remote history of schistosomal infection 20 years earlier while in Vietnam. Significant labs at presentation demonstrated a hemoglobin of 12.2 g/dL, calcium of 11.8 mg/dL, and acute renal failure with a creatinine of 3.9 mg/dL. A computed tomography scan demonstra...

Myelofibrosis is a slowly evolving pathology, characterized by increased myeloid cells and structural abnormality of the bone marrow matrix, which at end-stage manifests in excessive deposition of reticulin fibers and cross-linked collagen in the bone marrow, suppression of normal hematopoiesis and bone marrow failure. Clinically, myelofibrosis occurs secondary to a variety of hematologic condi...