Final answer:
The leukemia that requires a bone biopsy is acute lymphoblastic leukemia (ALL).
Step-by-step explanation:
The form of leukemia that is usually not able to be aspirated and requires a bone biopsy is acute lymphoblastic leukemia (ALL). ALL is a type of leukemia that primarily affects lymphocytes, which are a type of white blood cell.
A bone biopsy is necessary to obtain a sample of the bone marrow for examination because the leukemic cells mainly accumulate in the bone marrow.
One physical finding that may be present in ALL is an enlarged liver or spleen due to the infiltration of leukemic cells. On immunostaining, ALL is characterized by the presence of specific markers called cluster of differentiation (CD) antigens, such as CD19, CD20, and CD22, which can be identified using labeled antibodies.
This technique, known as immunohistochemistry, helps in identifying the type of leukemia.