An instrument for combined sternal biopsy and aspiration.

It is now universally agreed that examination of bone marrow aspiration material is essential for unravelling many haematological problems. In some cases, however, it is extremely difficult, or even impossible, to obtain specimens, as for example in the myelosclerotic and refractory anaemias. In the former, examination of the bone itself would be of value, and in the latter one would like to see the arrangement of the marrow elements in situ. In the past these difficulties were overcome by subjecting the patient to a minor operation when a bone biopsy was taken. With the instrument devised by Dameshek (1935), although satisfactory, a small skin incision before taking the biopsy specimen was found essential. In 1943 Turkel and Bethell produced an instrument which performed a sternal biopsy without the disadvantage of a skin incision and subsequent scarring. The instrument was simple to use and produced a thin core of bone with marrow attached. We have used this needle on several occasions, but found, as did the original authors, that if both biopsy and aspiration material were required a second needle of the usual Sahla pattern had to be inserted as a second operation. Our present modification of this needle, we think, overcomes this disadvantage and now affords a simple method of obtaining both aspiration and biopsy specimens for examination in the one puncture.