How are Biopsies Used to Diagnose Blood Cancer?

Reviewed by: HU Medical Review Board | Last reviewed: February 2018

A biopsy is a procedure in which a sample of tissue is removed from the body for examination under the microscope. Biopsies can be done on many different parts of the body and is generally needed to determine if cancer is present in the body. For blood cancer, common biopsies include a lymph node biopsy or a bone marrow biopsy. Some people with blood cancer may also have a skin biopsy.1

Types of procedures

Biopsies may be done as an out-patient procedure with local anesthesia (to help numb the area), or they may be performed as a surgical procedure using general anesthesia (sedative and pain medication) to make the patient unconscious during the procedure. There are different types of procedures that may be performed in a biopsy, including:

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  • A needle biopsy uses a needle to remove a small sample of cells or a core of tissue.
  • An open biopsy requires an incision (cut) to be made in the skin to access the tissue to be sampled.
  • An endoscopic biopsy involves a thin, flexible, lighted tube (endoscope) that is passed into the body where a sample of tissue can be removed.2

Lymph node biopsy

Some blood cancers require a lymph node biopsy to confirm diagnosis. In a lymph node biopsy, a lymph node or a part of one is removed through a surgical procedure. In some cases, a biopsy sample can be taken with a needle, however, the results are typically more conclusive with an open (surgical) biopsy.1

Bone marrow aspiration

Blood cancers often affect both the blood and the bone marrow, and a bone marrow aspiration and biopsy are generally needed to diagnose blood cancer. The bone marrow aspiration and biopsy are samples of bone marrow that are taken usually from the hip (pelvic) bone. The aspiration uses a large, hollow needle to remove some of the liquid bone marrow. Although anesthetic (pain relief) is used, most patients experience some pain for a brief time when the marrow is removed. The bone marrow biopsy is done at the same time with a large needle that is twisted in to remove a small piece of bone, as well as marrow. Patients usually feel pressure and tugging and may experience some brief pain.3,4

Skin biopsy

A skin biopsy, also called a cutaneous biopsy, removes a sample of tissue from the surface of the body. Skin biopsies are most commonly used to diagnose skin conditions but may be helpful in differentiating among sub-types of blood cancer if skin is involved, such as with a skin rash.2