Percutaneous bone biopsy: the importance of aspirated osseous blood.

The diagnostic value of the microscopic examination of bone core specimen versus osseous blood, obtained by 110 percutaneous biopsies performed on 100 patients, was evaluated. A diagnosis of malignancy was made by biopsy in 54 cases. In 52 cases in which osseous blood (clot and smears) was available for examination, a positive diagnosis for malignancy was made microscopically in 49 (94%). In 46 cases in which bone cores were studied separately, a microscopic diagnosis of malignancy was made from the bone core in 39 (85%). If osseous blood had not been available for examination only 39 (72%) of the 54 biopsies would have been positive for malignancy; the other 14 biopsies would have been classified as either negative or insufficient for diagnosis. In those biopsies where both bone cores and osseous blood were available, the osseous blood showed better malignant tissue morphology and was considered better diagnostic material in 19 cases, whereas bone cores were considered better diagnostic material in only three cases. Osseous blood, which is usually easily available in bone biopsies, is valuable diagnostic material; it should be treated as a tissue specimen and not discarded.