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Bilateral Bone-Marrow Biopsy

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Department of Internal Medicine
Southern California Permanente Medical Group
Panorama City, California 91402

Ann Intern Med. 1975;83(1):122-123. doi:10.7326/0003-4819-83-1-122
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To the editor: Brunning and associates (Ann Intern Med 82:365-366, 1975) advocate bilateral bone marrow biopsy in staging lymphomas and other neoplasms. To support their contention, they cite the "minimal discomfort" of the procedure and some very impressive percentages derived from their data.

I find their conclusion misleading. The Jamshidi needle biopsy is often more than minimally uncomfortable. In all cases, two biopsies are twice as painful as one. To justify the additional procedure, what are the chances that it will give additional information not provided by the first biopsy? Using their data, one can derive the answer of 4.2%


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