Bone biopsy

Specimen:

Trephine needle biopsy, open surgical biopsy or fine needle aspiration biopsy. The type of biopsy depends on the suspected diagnosis.

Method:

Fresh tissue is used for microbiological culture and cytogenetics (if indicated). In the majority of cases consultation between pathologist, radiologist and clinical staff is essential. 

Frozen section is uncommon as calcified tissue is unsuitable

Fixed tissue: light microscopy, morphometry and molecular genetics. If metabolic bone disease is suspected, pre-biopsy administration of tetracycline (in vivo tetracyline labelling) may be indicated - consult laboratory staff.

Application:

May be indicated to establish the diagnosis of bone cysts, osteomalacia, rickets, osteoporosis, Paget's disease, renal osteodystrophy, hyperparathyroidism, suspected osteomyelitis, and suspected primary and secondary neoplasms.

Interpretation:

The report by the pathologist will address the specific clinical problem such as diagnosis of demineralisation disorder, morphometric analysis for metabolic bone disease, identification and classification of benign tumours, and primary and secondary malignancy. 

See also Bone marrow biopsy.

Reference:

Rosai J. Rosai and Ackerman's Surgical Pathology. 10th Ed. Edinburgh: Elsevier, 2011; Chapters 23 and 24.