A biopsy is any test where cells or tissues are removed so they can be examined. Biopsies are commonly done before or instead of surgery, but you can also have a biopsy done during surgery.
Bone marrow tests
In this test a tiny sample of your bone or bone marrow is looked at under a microscope. There are two types of bone marrow tests:
- a bone marrow aspiration - collection of cells from the bone
- a bone marrow trephine biopsy - collection a 1-2 centimeter core of your bone marrow, which allows doctors to also examine your bone marrow structure.
You may have one or both tests done at the same time.
There is no preparation involved before the test. You will be given some local anaesthetic to numb the area – this is usually the hip, but if you are having just an aspirate it may be from your breastbone (sternum). The doctor will then gently insert the needle through the skin and into the centre of the bone where the marrow is.
If you are having an aspiration you will feel a pulling sensation as the doctor begins to draw the bone marrow cells out. If you are also having a trephine biopsy you will need to have a second needle, which is a little bit thicker. The doctor may need to push or rotate the needle to get a single piece of bone marrow out.
Unfortunately, it’s not possible to anaesthetise within the bone, so you may feel a sharp pain as the bone marrow is being taken out. However, the procedure is over very quickly and only takes around 15 minutes.
If you’re anxious about the procedure let your doctor know well before the test as they may be able to organise a sedative – however, this will impact the amount of time you will need to stay before you can go home.
If only local anaesthetic was used, you’ll be able to go home immediately afterwards. If you had a sedative you will need someone to collect you and stay with you afterwards. After the test, your hip will be sore for a couple of days, but over-the-counter painkillers should be suitable.
Lumbar punctures (also known as spinal taps) collect and examine cerebrospinal fluid (CSF), which floats around the brain and spinal cord.
There is no preparation required before the test. Once you arrive, you may need to change into a hospital gown and your doctor will ask you to lie on your side and to curl your knees up slightly.
The doctor will first inject some local anaesthetic. Once this takes effect they will carefully insert a thin needle between the vertebrae in your lower back and into the space around your spinal cord. When a few drops of cerebrospinal fluid have been collected the needle will be removed, with the whole procedure taking around 30 minutes.
You will need to remain still during the test, and may feel some discomfort as the needle goes in. There might also be some pain, although the anaesthetic usually helps.
After the test, will need to lie flat for a few hours to prevent getting a headache, but can usually go home afterwards.
An endoscope is a thin tube with a light and a camera on one end which is inserted into your body (usually without the need for surgery) so that your doctor can see the tissues more clearly. You must fast before this test. If your bowel is being tested, it must be empty so that your doctor can see the lining of your bowel clearly. Depending on the part of your body being tested, you may be given a light sedative to relax you beforehand.
There are many different types of endoscopies:
- An oesophagoscopy looks at your gullet (oesophagus)
- A gastroscopy looks at your stomach
- A colonoscopy looks at your large bowel
- A sigmoidoscopy looks at the lower end of your bowel
- A proctoscopy looks at your back passage (rectum)
- A laryngoscopy look at your larynx (voicebox)
- A bronchoscopy looks at your lung airways
- A mediastinoscopy looks at the space behind your breastbone between your lungs
- A cystoscopy looks at your bladder
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