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Bone marrow, smear interpretation

CPT4 code

Name of the Procedure:

Bone Marrow, Smear Interpretation
Common names: Bone Marrow Aspiration and Smear Interpretation, Bone Marrow Biopsy and Smear Interpretation

Summary

Bone marrow smear interpretation is a diagnostic procedure in which a sample of bone marrow is collected, typically from the hip bone, and then examined under a microscope. This helps doctors diagnose various blood disorders and diseases.

Purpose

The procedure is conducted to diagnose and monitor blood diseases like leukemia, anemia, and bone marrow disorders. It helps in identifying abnormal cells, assessing bone marrow function, and planning further treatments.

Indications

  • Unexplained anemia or low blood counts
  • Suspicion of leukemia or other cancers
  • Monitoring of known bone marrow diseases
  • Diagnosis of unusual infections or inflammatory conditions

Preparation

  • Patients may be advised to stop certain medications before the procedure.
  • Fasting for a few hours prior to the procedure may be required.
  • Blood tests and imaging studies may be conducted beforehand.
  • Consent forms will need to be signed.

Procedure Description

  1. The patient will lie on their side or stomach.
  2. The skin over the hip bone area is cleaned and numbed with a local anesthetic.
  3. A special needle is inserted into the bone to draw out a small amount of marrow.
  4. The collected sample is placed on slides and stained for microscopic examination.
  5. The skin is then bandaged.

Tools/Equipment: Aspirating needle, slides, staining agents, microscope.
Anesthesia: Local anesthesia is applied to numb the area.

Duration

The procedure typically takes about 20 to 30 minutes, including preparation and post-procedure care.

Setting

Bone marrow aspiration and smear interpretation are usually performed in a hospital, outpatient clinic, or a specialized surgical center.

Personnel

  • Hematologist or oncologist
  • Nurse or medical technician
  • Occasionally, a pathologist for immediate analysis

Risks and Complications

  • Soreness and bruising at the site of the needle insertion
  • Bleeding or infection at the puncture site
  • Rarely, injury to surrounding tissues

Benefits

The results can provide critical information on the nature and cause of blood disorders, aiding in precise diagnosis and effective treatment planning. Results are typically available within a few days.

Recovery

  • Patients may be monitored for a short time after the procedure.
  • Pain management includes over-the-counter pain relievers.
  • Avoid strenuous activities for a couple of days.
  • Follow-up appointments may be necessary to discuss results and further treatment.

Alternatives

  • Peripheral blood smear examination
  • Imaging tests like MRI or CT scans
  • Genetic testing or molecular studies

Pros and Cons: Peripheral blood smear is less invasive but may not provide as detailed information. Imaging studies are non-invasive but might not detect cellular-level abnormalities.

Patient Experience

During the procedure, patients might feel a brief sharp pain or pressure when the needle is inserted. After the procedure, minor discomfort or soreness is normal and can be managed with pain relievers and rest.

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