Medical Tests, Diagnosis & Detection
In order to establish a correct diagnosis of leukemia, the doctor follows
Anamnesis (detailed medical review of past health state):
the first steps in establishing a leukemia diagnosis is a detailed and
complex medical review of a patient's past health problems and general
health state, family medical history, leukemia risk factors, and symptoms.
During a physical examination, the doctor looks for changes to the internal
organs like swelling of the liver, spleen, or lymph nodes from the neck,
underarms, and groin area.
Blood test: A blood test allows the pathologist
to examine the blood cells under a microscope. The examination
criteria are: (1) the blood cells' general appearance, (2)
the number of each type of blood cells (red and white cells,
and platelets), (3) the cell maturation stage, and (4) the
presence or absence of leukemia blast cells. Blood tests are
also conducted to diagnose and establish the type of leukemia.
Bone marrow test: This test allows the
pathologist to examine the marrow cells. It usually confirms
the presence or absence of leukemia and the leukemia type.
The bone marrow sample can be collected in two ways: (1) through
a bone marrow aspiration - the bone marrow sample is removed
with a thin needle inserted into the marrow of a large bone,
and (2) through biopsy - the bone marrow sample is removed
together with the bone tissue.
Spinal tap: This test allows the pathologist
to examine the cerebrospinal fluid (the fluid located in and around
the brain and spinal cord), and to confirm the presence of leukemia
cells. A cerebrospinal fluid sample is removed through a lumbar
puncture. A thin needle is inserted into the space around the spinal
cord and removes a sample of fluid. This test is performed only
when the leukemia diagnosis was confirmed with the purpose of establishing
whether or not the leukemia cells had spread to other internal organs.
Immunophenotyping: An immunopheno type test
helps identify the chemicals located on the cells' surface and diagnose
the disease by placing various sorts of strain on bone marrow, blood,
or lymph nodes cells. For leukemia, the pathologist uses antigens
(proteins) and the bodys antibodies. The antibodies react
to certain antigens. This test helps in identifying leukemia cells
(if present), the type of leukemia cells (lymphocytic or myelogenous
cells), and the cell subtype, which helps establish a treatment
Cytogenetics or chromosome analysis. This test
analyzes the shape and number of the chromosomes from the leukemia
cell, and can identify the chromosome alteration and sometimes the
gene mutation. The advantages of this test are: (1) it identifies
the specific leukemia type involved, (2) it helps with establishing
an effective treatment plan, and (3) it allows follow-up evaluations
of the treatment effectiveness.
The purpose of these techniques is to locate masses of
leukemia cells inside the body. Some of the most used imaging techniques
Chest X-rays: An x-ray test uses high energy
electromagnetic radiation to penetrate the body and create
an image of the body's interior on film. An x-ray can reveal any
possible mass of leukemia cells in the chest.
Ultrasounds: Ultrasound imaging is a medical
technique that uses high-frequency sound waves to create an interior
image of the body on a special computer screen. This image is formed
from the echoes of the sound waves on the surface of the organs.
Abnormal tissue masses and organs reflect sound waves differently.
This test involves a device called a transducer that is placed on
the upper part of the abdomen, and a computer that translates this
sound into an image. Ultrasound imaging is a safe, noninvasive and
fast test that can detect leukemia cell masses. Usually, ultrasounds
are used to detect whether or not the liver, kidneys, or the spleen
were invaded by the leukemia cells.
Bone or Gallium Scan: This is usually used
to detect whether or not the bone pain (a symptom of leukemia) is
caused by a tumor. This type of bone scan uses a radioactive form
of gallium which collects in the areas where there are leukemia
cells or infections.
Computed Tomography (CT): This imaging test
is similar with an x-ray test, and creates a detailed cross-sectional
image of the body.
A CT scan is usually performed in two steps for a better
1). First, the targeted area is scanned without a contrast
2). Second, the targeted area is scanned after a contrast agent was
administrated, and the two are compared.
Article by Alina Morrow, MS
Leukemia is sometimes misspelled as lukemia
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