NCCN Guidelines for Patients
Multiple Myeloma, Version 1.2014
Tests for myeloma
To confirm if you have cancer, a sample of tissue or
fluid must be removed from your body for testing. This
is called a biopsy. A biopsy is generally a safe test
and can typically be done in about 30 minutes. After
the samples are collected, they are sent to a lab for
testing. A pathologist will examine the samples with a
microscope to look for myeloma cells. The pathologist
may also perform other tests on the samples. It
usually takes several days before the results are
known. The three types of biopsies used for myeloma
are described below.
Bone marrow aspiration and biopsy
A bone marrow biopsy removes a small piece of solid
bone along with a small amount of soft bone marrow
inside the bone. A bone marrow aspiration removes
a small amount of liquid bone marrow (called an
aspirate) from inside the bone. Usually both tests are
done at the same time on the hip bone.
These biopsies are done as outpatient tests—this
means you do not have to spend the night in the
hospital. First, you may be given a sedative injected
with a needle into your vein. Your doctor will then
clean the area of skin where the biopsy will be
performed. Next, you will receive local anesthesia to
numb the area of skin and bone beneath. After the
area is numbed, a hollow needle will be inserted into
your skin and then pushed into the bone to remove
the liquid bone marrow with a syringe. Then, a wider
needle will be inserted into the bone to remove the
solid bone and marrow sample.
See Figure 2.1.
may feel some pain while the samples are being
removed and your skin may be bruised afterward.
If you have a solitary plasmacytoma, a tissue biopsy
may be done to remove a sample of the mass for
testing. The sample is often removed with a needle.
This can be done either with a fine-needle aspiration
biopsy or a core needle biopsy. A fine-needle aspiration
biopsy uses a very thin needle to remove a small
sample from the mass. A core needle biopsy uses a
larger needle to collect a larger sample of tissue. For
a tissue biopsy, an imaging test may be used to guide
the needle through the skin and into the mass.
Bone marrow biopsy
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