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To find the cause of a person's symptoms, the doctor asks about the patient's medical history and does a physical exam. In addition to checking general signs of health, the doctor feels for swelling in the liver, the spleen, and in the lymph nodes under arms, in the groin, and in the neck.
Blood tests also help in the diagnosis. A sample of blood is examined under a microscope to see what the cells look like and to determine the number of mature cells and blasts. Although blood tests may reveal that a patient has leukemia, they may not show what type of leukemia it is.
To check further for leukemia cells or to tell what type of leukemia a patient has, a hematologist, oncologist or pathologist examines a sample of bone marrow under a microscope. The doctor withdraws the sample by inserting a needle into a large bone (usually the hip) and removing a small amount of liquid bone marrow. This procedure is called bone marrow aspiration. A bone marrow biopsy is a performed with a larger needle and removes a small piece of bone and bone marrow.
If leukemia cells are found in the bone marrow sample, the patient's doctor orders other tests to find the extent of the disease. A spinal tap (lumbar puncture) checks for leukemia cells in the fluid that fills the spaces in and around the brain and spinal cord (cerebrospinal fluid). Chest x-rays can reveal signs of disease in the chest.
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