Diagnosing Leukemia and Lymphoma

Using testing to diagnose cancers of the blood.

Certain symptoms may suggest you have leukemia, lymphoma, myeloma, or a related condition such as aplastic anemia. But tests will be needed to diagnose the specific type of cancer you have.

Our hematologic-oncology team may recommend one or more of the following diagnostic tests:

Blood tests

These will tell us if you have abnormal levels of red or white blood cells or platelets.

Bone marrow aspiration and biopsy

These procedures are used to collect samples of bone marrow, the spongy tissue inside your larger bones.

  • Bone marrow aspiration collects the fluid portion of bone marrow.
  • Bone marrow biopsy removes a sample of the solid portion of bone marrow.

You will be given IV sedation or local anesthesia. For aspiration, the doctor will insert a long, hollow needle with a syringe attached into your hip bone to withdraw a fluid sample. A larger needle will be used to withdraw a solid bone marrow tissue sample.

These procedures usually take about 30 minutes. You can return to your normal daily activity as soon as you feel ready, although you may feel some tenderness for a week or more.

Lumbar puncture

Also known as a spinal tap, this procedure is used to detect whether blood cancer cells are present in cerebrospinal fluid surrounding the brain and spinal cord. Your doctor will numb your lower back with a local anesthetic and insert a needle between two vertebrae (the bones that make up your spine) and into your spinal canal. Once the needle is positioned, spinal fluid pressure is measured and a sample is collected.

Lymph node biopsy

This procedure tests enlarged lymph nodes for cancerous cells. There are a few ways we do lymph node biopsies:

  • Needle biopsy: The doctor inserts a thin needle to remove a sample of cells.
  • Open biopsy: The doctor makes a small incision to remove the lymph node.

Imaging tests

One or more imaging tests may be used to detect bone problems associated with myeloma. These can include:

Physical exam

The doctor will look for symptoms such as pale skin or enlarged lymph nodes, spleen, and liver.

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