stage 4 lymphoma l What is the difference between medullary puncture and medullary biopsy?

What is the difference between medullary puncture and medullary biopsy?

The puncture and medullary biopsy are "classical" tests in the context of lymphoma. Sometimes we have both (what luck!) but sometimes only one of the two.
Many of you have already asked me questions about this: what is the difference? What's the point? Is it painful? What more are we looking for in this exam? Etc. I remind you that I am not a doctor (not at all) Lol. I can help you but on condition to inform me on the subject, because my only experience as a patient does not necessarily reflect the reality... So I will try to enlighten you on some of the issues.
These tests are performed when there is a biological anomaly in the white blood cells, red blood cells or platelets.

What is bone marrow? The bone marrow is the soft, spongy tissue that is found inside most bones. Immature blood cells are transformed into red cells, white cells or platelets in the bone marrow.

Why prescribe these exams? To see if the bone marrow produces the normal number of blood cells, know why the number of blood cells is abnormal, diagnose blood disorders, diagnose cancer of the blood or bone marrow (lymphoma or leukemia), Diagnose extensive metastasis to the bone marrow, monitor the reaction to treatment for bone marrow cancer, or before a stem cell transplant.

– Medullary puncture:

Also called Myelogram.

This test involves taking a few grains of bone marrow from the syringe aspiration. Usually it is done at the sternum (thorax) or pelvic bone (pelvis).

The aim is to study the elements of hematopoietic tissue numerically and morphologically in order to analyse bone marrow dysfunction. The sampling tells us about the quality and quantity of the cells.

The puncture is quick to do but quite unpleasant (at the time of aspiration) and impressive. This is a particularly appropriate examination in the case of Hodgkin's.

– Medullary biopsy: It consists of taking a bone marrow core for histological examination of the hematopoietic tissue.

The small cylindrical fragment (carrot) of the bone marrow taken is between 15 and 30 mm long and 1.2 to1, 5 mm in diameter. The specimen is taken from the pelvic bone (pelvis). This allows a cytological study (of cells) that more accurately observes the richness of the marrow, its architecture. It can help prevent the puncture.

Personally, I had a medullary biopsy because the Pet Scan seemed to indicate a bone marrow damage for my Hodgkin (and thus a stage 4). In order to have confirmation, a biopsy was programmed on the 1st day of my chemo (the treatment for a stage 3 or 4 is identical so it does not change much). To be honest, this is not a nice review. In my case, I had just been hospitalized and I knew that after the biopsy, the chemo would arrive so it was a lot of stress in a short time....  The local anesthesia that we are being made does not allow the exam to be painless. The doctors propose a supplement: either the Mask (as in the operating room) or hypnosis (if they know how to do it) and for the most anxious, they can offer you a small relaxing cocktail (antidepressant, anxiolitique). I opted for hypnosis! I must be totally insane! In fact, the doctors had advised me against the mask to prevent me from being in the gas for my first chemo.... So the nurse cadre did the hypnosis. Frankly I did everything to stay focused and relax but I am not very receptive (but I do not regret to have tested). It's a little confusing to have several people preparing behind your back: the preparation is long and impressive. And then I had the chance to serve as a guinea pig for internal and external... I hope they learned well! And, for those who ask the question, yes one feels pain but hey I'm not dead either.... And the medical team is well aware that the exam is not pleasant so they are very friendly, listening, etc.... Once the exam was finished, they put a big compressive dressing (in the lower back) with the obligation to lie down for 1h-1h30 on the back in order to compress well and avoid a hematoma. On the other hand I do not tell you the galley to remove the big band of Elastoplast a few days later..... And in the end, big surprise since the result came back negative! The review is therefore useful.