A 28-year-old black man was admitted in 1959 with fever, hepatomegaly, and pulmonary infiltrates. Tuberculosis was suspected but the sputum examination was negative. Needle biopsy of the posterior iliac crest (Westerman-Jensen needle) revealed granulomas (see figure) and the culture was positive for Mycobacterium tuberculosis. This prompted the initiation of isoniazid, steroids, and streptomycin. A repeat bone marrow biopsy 7 weeks after the diagnosis showed no granulomas. The biopsy in this patient was the first use of a needle biopsy for the diagnosis of systemic disease. In the subsequent 53 years, the needle marrow biopsy has become routine to obtain additional information on metastatic neoplasms, staging of lymphomas, estimation of bone marrow cellularity, fibrosis, and iron stores, and for evaluation of metabolic bone diseases.