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Considering a Bone Marrow Biopsy: My Concerns

9/15/2025, 4:50:23 PMMale25-34

Hello everyone. I’m a 44-year-old male dealing with an enlarged spleen, yet my flow cytometry results indicate everything is normal. Below is a brief history of my situation. My hematologist has suggested that I undergo a bone marrow biopsy, but I’m uncertain about proceeding with it. Although they claim the procedure is painless, I've heard from several sources that discomfort can linger for months or even years. Additionally, I'm apprehensive about the unnecessary exposure to radiation, which a technician indicated could be equivalent to 100 chest X-rays. - I previously reported some intermittent pain on my right side to my primary care physician, who subsequently recommended an abdominal ultrasound. - The ultrasound detected a 20 cm spleen, leading to a referral to a hematology specialist. - As part of the evaluation, hematology requested a flow cytometry test to exclude conditions like leukemia and lymphoma; fortunately, the results came back completely normal. - However, the hematologist did raise the possibility of splenic marginal zone lymphoma. - I also have a history of GERD and am currently testing positive for H. pylori. My hematologist suggested that H. pylori might be linked to my enlarged spleen, but my gastroenterologist firmly disagrees, stating that H. pylori does not affect the spleen. - I had an upper gastrointestinal endoscopy (EGD) expecting treatment for H. pylori, but the procedure showed no issues, and the biopsy results came back negative for H. pylori, despite a positive stool test. Neither my gastroenterologist nor my primary care doctor plans to provide treatment for the H. pylori. - The hematologist anticipated that I would be given antibiotics for H. pylori and suggested we monitor if the spleen size decreases afterward. However, with no treatment planned now, I feel uncertain about my next steps.

Multiple SclerosisLupusRheumatology

Answers (1)

Cony

9/15/2025, 4:50:42 PM

OpenHealth AI

Your concerns about the bone marrow biopsy and the ongoing questions about your enlarged spleen and H. pylori are valid and understandable. Here’s a structured overview to help clarify your situation:

Main Points

  1. Bone Marrow Biopsy: It's a common procedure that can provide important insights, especially related to your hematologist's concerns about your spleen.
  2. Enlarged Spleen and H. pylori: The relationship between H. pylori and spleen enlargement is unclear, but treating H. pylori may be beneficial in resolving other symptoms.
  3. Symptom Management and Monitoring: Given the complexity of your symptoms, it's essential to monitor your condition closely while addressing your concerns about treatment and procedures.

Explanation

A bone marrow biopsy involves taking a small sample of bone marrow to check for abnormalities that might explain your enlarged spleen, such as certain blood cancers. While the procedure can cause some discomfort, many patients report it is manageable, with recovery typically being quick. As for the exposure to radiation, a bone marrow biopsy does not involve radiation like an X-ray; your anxiety about radiation exposure may stem from misunderstandings, so it’s good to clarify this with your hematologist.

Regarding H. pylori, while it's true that some professionals may disagree about its role, the link between H. pylori and splenic issues is not well-established. Successful treatment of H. pylori is important since it can lead to other gastrointestinal problems, and if a course of antibiotics is suggested, it is generally advisable to follow through.

Next Steps

  1. Discuss Concerns with Your Hematologist: Schedule a direct conversation about your fears regarding the biopsy. Ask specific questions about the procedure, potential discomfort, and how it could help clarify your condition.

  2. Seek a Referral for a Gastroenterology Second Opinion: Given the conflicting views on H. pylori, another gastroenterology opinion may provide clarity. They can evaluate if treatment is warranted based on your recent tests and symptoms.

  3. Monitor Your Symptoms: Keep track of any changes in your symptoms, including pain or any new developments. This information is valuable for your healthcare team.

  4. Consider a Support Network: Engaging with others who have similar experiences, either through online forums or support groups, can provide comfort and shared insights.

Taking these steps may help bring you peace of mind while ensuring that your health is carefully monitored and addressed. If you have further questions or concerns, please feel free to ask!

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