Bone Lesion Biopsy

Written by Brian Krans | Published on June 4, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

What is a Bone Lesion Biopsy?

A bone lesion biopsy is a surgical procedure in which a sample of your bone tissue is removed and tested in a laboratory. The test is typically used to distinguish between cancerous and noncancerous bone tumors and to diagnose other bone abnormalities.

The procedure involves making a small incision, drilling into the bone, and removing a sample of tissue from the lesion inside the bone. A lesion is an abnormality in the structure of the bone, which may or may not impact bone growth. Not all lesions are cancerous.

The Purpose of a Bone Lesion Biopsy

Your doctor may order a bone lesion biopsy if there are signs of abnormalities in your bones. These may show up on imaging scans, such as X-rays or CT scans. A biopsy helps doctors determine if your bone lesions are caused by cancer, infection, or another condition.

Conditions associated with bone tumors or lesions include:

  • coccidiomycosis (fungal infection)
  • Ewing’s sarcoma (cancerous bone tumor that affects children)
  • fibroma (benign tumor)
  • histoplasmosis (fungal infection)
  • multiple myeloma (cancer of the bone marrow involving plasma cells)
  • mycobacteria infection (tuberculosis)
  • osteoblastoma (benign bone tumor)
  • osteoid osteoma (benign bone tumor)
  • osteomalacia (softening of the bones due to a lack of vitamin D)
  • osteomyelitis (bone infection)
  • osteosarcoma (cancerous bone tumor that usually appears during adolescence)
  • osteitis fibrosa (softening of the bones due to hyperparathyroidism)
  • rickets (weakening of the bones due to lack of calcium, vitamin D, or phosphate)

Bone lesion biopsies can also provide surgeons with an inside view of your bones. This is helpful when inspecting the status of infections or diseases that could be treated with amputation, such as osteomyelitis. In some cases, the biopsy can help prevent the need for an amputation.

How to Prepare for a Bone Lesion Biopsy

Prior to your surgery, you’ll have imaging tests to determine the location of your bone lesions. Using these images, your surgeon will select the area from which a tissue sample will be taken.

You will also undergo a physical examination. This is a good time to tell your doctor about any medications you are taking (even over-the-counter medicines or supplements) and any allergies you may have.

You will most likely be instructed to fast for eight hours before your biopsy. This is standard procedure, especially if you are undergoing general anesthesia.

How a Bone Lesion Biopsy Is Performed


The location and type of biopsy will determine the type of anesthesia you need. You may have local, site-specific anesthesia or you may need general anesthesia. Under general anesthesia, you will be in a painless sleep during the entire biopsy.

The Incision

During the procedure, your surgeon will make a small incision in your skin above the bone that is going to be biopsied. What happens next depends on the type of biopsy you are having.

Needle Biopsy

A small hole will be drilled into the bone. Your surgeon will extract a tissue sample using an instrument similar to a needle.

Incisional Biopsy

The surgeon cuts directly into the tumor to remove a sample. This type of biopsy can be used to retrieve a larger tissue sample.

After the sample is removed, your incision wound is stitched closed and dressed. The tissue sample is then sent to a laboratory for testing.

The Risks of Bone Lesion Biopsy

All surgical procedures carry risks of infection and bleeding, which are greater for people with bleeding disorders or a compromised immune system. Tell your doctor if you have either of these risk factors.

Other complications specific to bone lesion biopsies include:

  • damage to surrounding tissue
  • excessive bleeding
  • bone fractures
  • infection of the bone or near the biopsy area

The risks of this test are significantly lower than the risk of not having your bone lesions tested. Testing can help detect cancers or other serious health problems so that treatment can begin as quickly as possible.

Following Up After a Bone Lesion Biopsy

After the biopsy, you will rest in a hospital bed until your doctor tells you it is OK to go home. You will be in charge of taking care of your incision wound, which includes keeping the area clean and changing your bandages. Your doctor will remove your stitches at a follow-up appointment. The site of the biopsy may be sore for a few days after the procedure.

Your doctor will go over the results of your biopsy at a follow up appointment. He or she will tell you whether the tumor or lesion on your bone is cancerous and, if so, what your treatment options are.

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