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How is Leukemia diagnosed ?

Leukemia can be diagnosed with a variety of tests, and understanding what each test is and what it looks for can make the tests a little less confusing. Doctors sometimes find leukemia after a routine blood test. If you have symptoms that suggest leukemia, your doctor will try to find out what’s causing the problems. Your doctor may ask about your personal and family medical history.

Physical Examination
An exam is much like any doctor’s appointment; the doctor will take a detailed medical history and thoroughly examine the whole body.
Blood Tests
To diagnose leukemia, a number of blood tests are performed. These tests are used to evaluate the type and quantity of blood cells that are present, the blood chemistry, and other factors.
Full blood count
It is used to establish the numbers of different blood cell types in the circulation. A low number of red or white blood cells is described as anemia or leukopenia, respectively.
Bone Marrow Biopsy
A biopsy takes a small sample of bone marrow tissue from the body. The doctor asks the patient to lie on his or her side and nurses clean the biopsy site with iodine or alcohol. After the site is cleaned, the biopsy site is numbed with a local anesthetic. The doctor uses either a very fine needle to draw out only bone marrow tissue, or a thicker needle to take a small sample of bone and bone marrow. The bone marrow sample is examined under a microscope to check for leukemia cells.
Cytogenetics
It is a newer type of testing for leukemia. Cytogenetic testing uses a sample taken from a blood draw or a bone marrow or lymph node biopsy. The sample’s chromosomes are microscopically examined for abnormalities that indicate damage to the cells’ DNA.
Spinal tap
The doctor uses a long, thin needle to remove fluid from the lower spine. The procedure takes about 30 minutes and is performed with local anesthesia. You must lie flat for several hours afterward to keep from getting a headache.
Chest x-ray
An x-ray can show swollen lymph nodes or other signs of disease in your chest.
CT scan of the head, chest, and belly, to find out whether leukemia has spread there.
Lumbar puncture is to find out whether leukemia cells are in your cerebrospinal fluid (CSF).
Differential blood count (DBC)
It is used to determine the relative proportion of blood cell types within the bloodstream. In particular, the percentage of immature leukemic “blast” cells is noted.
Hematocrit assay
It is used to determine the proportion of the blood that is occupied by erythrocytes (red blood cells). In adult men, normal is about 46% (39.8–52.2) and in adult women, it is about 40.9% (34.9–46.9).

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