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Bone marrow samples can be obtained by aspiration and trephine biopsy.
A trephine biopsy should never be performed on the sternum, due to the risk of injury to blood vessels, lungs or the heart.
Bone marrow aspiration and trephine biopsy are usually performed on the back of the hipbone, or posterior iliac crest.
Bone marrow examination refers to the pathologic analysis of samples of bone marrow obtained by bone marrow biopsy (often called a trephine biopsy) and bone marrow aspiration.
Frequently, a trephine biopsy is also obtained, which yields a narrow, cylindrically shaped solid piece of bone marrow, 2mm wide and 2 cm long (80 μL), which is examined microscopically (sometimes with the aid of immunohistochemistry) for cellularity and infiltrative processes.
Depending on the nature of the myeloproliferative disorder, diagnostic tests may include red cell mass determination (for polycythemia), bone marrow aspirate and trephine biopsy, arterial oxygen saturation and carboxyhaemoglobin level, neutrophil alkaline phosphatase level, vitamin B (or B binding capacity) and serum urate.