Biopsy

A small piece of tissue is taken out of the body and tested for cancer cells.

An open biopsy is when when the skin is opened during surgery to get a sample
A closed biopsy is when a needle is put into the tissue without cutting open the skin.
Some biopsies are done in the operating room under general anesthesia (completely asleep). Other biopsies are done using local anesthesia (numbing the skin and tissues). The type of anesthesia used will depend on where the tumor is in the body and the condition of your child.

Bone Marrow Aspirate

A bone marrow aspirate is a test that is done to see if cells in the bone marrow are healthy and to find out if the cancer cells have spread to the bone marrow from another part of the body.

Bone marrow is the factory where blood cells are made. Bone marrow is found in the center of bones and is made up of both spongy bone and liquid marrow.
For this test, a needle is placed in the bone (usually the hip bone) and a small sample of liquid bone marrow is pulled into a syringe. The marrow is sent to the laboratory to be tested for cancer cells.
This test may be painful. There are many ways to decrease pain. Talk with your healthcare team about the ways CHOC Children’s manages pain with bone marrow aspirates.
There is a small chance that your child could bleed under the skin or get an infection where the needle was placed.

Bone Marrow Biopsy

While a bone marrow aspirate is done to look at blood cells in the bone marrow, a bone marrow biopsy is done to study an actual piece of spongy bone marrow.

Bone marrow biopsies also help determine if the one marrow cells are healthy and if there are cancer cells present.

For this test, a needle is placed in a bone (usually the hipbone), and a small piece of the spongy bone marrow is removed and sent to the laboratory for testing.

Lumbar Puncture

A lumber puncture (also called a spinal tap) is a test done to see if there are cancer sells in the fluid that cushions the brain and spinal cord. This fluid is called cerebrospinal fluid or CSF.

Your child will be asked to lie on their side with the chin tucked to the chest and knees pulled up. In some cases children can sit up and curl the back by tucking the chin to the chest. When the back is in a curved position , a needle can be placed in between the bones of the spine (vertebrae). Fluid from the spinal canal can then be removed through the needle and dripped into a tube that is sent to the laboratory to be tested. For some types of cancer, chemotherapy may be given into the spinal canal through the same needle after the fluid is removed for testing.

This test may be painful. There are many ways to decrease pain. Talk with your health care team about the ways CHOC Children’s manages pain with lumbar punctures. Some children may have a headache or backache after the test. After the test there is a small chance that your child may get an infection or bleed under the skin.