Trephine Biopsy

Trephine biopsy is an examination that is especially important in hematology (a special branch of internal medicine dealing with blood disorders). The aim is to obtain a sample of bone marrow with a special needle.


The sampling is performed most frequently from the iliac crest. The patient lies in horizontal position on his back or on the side. The site of biopsy is disinfected. The main procedure has usually two steps. First puncture serves for aspiration of cells similarly as in sternal puncture. The second phase includes the use of a special strong needle that enables to obtain the main sample of bone marrow tissue.


The procedure does not require special preparation and it is usually performed under local anesthesia.


Trephine biopsy allows us to examine a sample of bone marrow with its preserved structure. It has a huge significance in confirmation of hematological diseases (e.g. leukemias). Sternal puncture is a simpler and less painful procedure, but it obtains only aspirated cells suitable for cytological examination. The sample from the trephine biopsy may be examined histologically, which gives the examiner the possibility to better evaluate the architectonic structure of the tissue and better diagnose any disorders.


The trephine biopsy may be painful and it is generally not a very pleasant examination. The site of the biopsy may bleed and there is also certain risk of local infection, which is however minimized by strictly sterile conditions. Given the risk of bleeding, the indication of this examination method should be cautiously weighed in people with severe disorders of blood clotting.


The main advantage is the possibility to obtain a histological sample of bone marrow with the opportunity to evaluate its structure and architectonics, which significantly improves the diagnostics of blood disorders.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources