A Trephine Modified to Secure Bone Marrow (Sternal) Biopsies

The trephine here devised and illustrated as to its parts (fig. 1) is modified from the various puncture needles (Ghedini, Arinkin, Seyfarth and others), long suggested to get marrow specimens safely both for histologic embedding and for smears for routine staining. The sternum is ideally adapted as a source, both because of ease of access and because of its persistent functional activity throughout life. The ribs are equally active but not so simple to approach. Isaacs has correctly criticized simple needle puncture methods as really yielding mixtures of marrow elements washed out with traumatically induced blood flow. Thus one has blood with certain marrow admixtures. We have found this true, especially when the marrow system is inactive. Ordinary chronic myeloid leukemia, however, yields needle puncture material so readily that smears so closely resemble ordinary blood smears as to make the observer feel that he