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Your doctor can diagnose acute leukemia based on a physical exam, medical questions, and tests that look at a person's blood and bone marrow cells.
**Medical History**
Your doctor will ask about your medical history to gather information about your health habits, past illnesses, and treatments.
**Physical Exam**
Your doctor will perform a general physical exam. This exam checks your physical health for any unusual findings or symptoms. During the physical exam, your lymph nodes, spleen, and liver will be examined for enlargement.
**Complete Blood Count (CBC)**
A blood sample is collected and examined to measure various parameters:
* The amount of red blood cells (RBCs), white blood cells (WBCs), and platelets (clotting cells)
* The amount of hemoglobin attached to red blood cells
* The proportion of the sample made up of red blood cells, called the hematocrit
**Blood and Urine Chemistry Tests**
This is an analysis of a blood sample that measures the levels of certain substances released by organs and tissues into the bloodstream. Unusually high or low levels of these substances can help in the diagnosis of disease.
**Peripheral Blood Smear**
Your doctor examines your blood sample under a microscope to look for changes in the shape of blood cells. This is very important in diagnosing acute myeloid leukemia. Your doctor can also determine the quantity, type of white blood cells, and platelet count.
**Bone Marrow Aspiration and Biopsy**
Bone marrow aspiration and biopsy is a procedure to collect and examine bone marrow, a spongy tissue found in some of your larger bones. It is used to diagnose and monitor acute leukemia. Bone marrow biopsy and bone marrow aspiration are most often done at the same time.
Bone marrow aspiration and biopsy are usually taken from the top of the back of the hip bone. The skin and subcutaneous tissues are penetrated with a needle, which is then advanced into the bone marrow. The hematologist or oncologist performing the biopsy attaches a syringe to the needle to collect a sample of the liquid portion of the bone marrow. Aspiration only takes a few minutes. If no marrow fluid is obtained, the procedure may be repeated. Sometimes, due to the condition of the illness, no bone marrow fluid can be aspirated. In this case, only a biopsy is taken. For a bone marrow biopsy, a larger needle is used to obtain a solid core sample of bone marrow tissue, at least 1.5 cm (1.5-3.5 cm) long, to ensure a sufficient sample. Like aspiration, a biopsy also takes only a few minutes. Both samples are then examined under a microscope by a hematologist and pathologist to look for leukemia cells and monitor healthy blood cells. Acute leukemia can be diagnosed when leukemia cells are above a certain percentage in the bone marrow.
**Genetic Analysis**
After your bone marrow sample is taken, the tissue cells are analyzed under a microscope to look for genetic abnormalities.
**Immunohistochemistry**
This is an analysis of antigens, which can be thought of as identification markers, found on the surface of bone marrow cells.
**Flow Cytometry**
Flow cytometry reveals other characteristics of cells such as the size, shape and presence of tumor markers on the cell surface. For this test, cells are tagged with a fluorescent dye and placed in a liquid. A beam of light is passed through the cells, and the scattering of the light reveals the characteristics of the cells. It is an essential analysis in the diagnosis of acute leukemia.
What is the difference between core needle biopsy and fine needle aspiration biopsy?
**Medical History**
Your doctor will ask about your medical history to gather information about your health habits, past illnesses, and treatments.
**Physical Exam**
Your doctor will perform a general physical exam. This exam checks your physical health for any unusual findings or symptoms. During the physical exam, your lymph nodes, spleen, and liver will be examined for enlargement.
**Complete Blood Count (CBC)**
A blood sample is collected and examined to measure various parameters:
* The amount of red blood cells (RBCs), white blood cells (WBCs), and platelets (clotting cells)
* The amount of hemoglobin attached to red blood cells
* The proportion of the sample made up of red blood cells, called the hematocrit
**Blood and Urine Chemistry Tests**
This is an analysis of a blood sample that measures the levels of certain substances released by organs and tissues into the bloodstream. Unusually high or low levels of these substances can help in the diagnosis of disease.
**Peripheral Blood Smear**
Your doctor examines your blood sample under a microscope to look for changes in the shape of blood cells. This is very important in diagnosing acute myeloid leukemia. Your doctor can also determine the quantity, type of white blood cells, and platelet count.
**Bone Marrow Aspiration and Biopsy**
Bone marrow aspiration and biopsy is a procedure to collect and examine bone marrow, a spongy tissue found in some of your larger bones. It is used to diagnose and monitor acute leukemia. Bone marrow biopsy and bone marrow aspiration are most often done at the same time.
Bone marrow aspiration and biopsy are usually taken from the top of the back of the hip bone. The skin and subcutaneous tissues are penetrated with a needle, which is then advanced into the bone marrow. The hematologist or oncologist performing the biopsy attaches a syringe to the needle to collect a sample of the liquid portion of the bone marrow. Aspiration only takes a few minutes. If no marrow fluid is obtained, the procedure may be repeated. Sometimes, due to the condition of the illness, no bone marrow fluid can be aspirated. In this case, only a biopsy is taken. For a bone marrow biopsy, a larger needle is used to obtain a solid core sample of bone marrow tissue, at least 1.5 cm (1.5-3.5 cm) long, to ensure a sufficient sample. Like aspiration, a biopsy also takes only a few minutes. Both samples are then examined under a microscope by a hematologist and pathologist to look for leukemia cells and monitor healthy blood cells. Acute leukemia can be diagnosed when leukemia cells are above a certain percentage in the bone marrow.
**Genetic Analysis**
After your bone marrow sample is taken, the tissue cells are analyzed under a microscope to look for genetic abnormalities.
**Immunohistochemistry**
This is an analysis of antigens, which can be thought of as identification markers, found on the surface of bone marrow cells.
**Flow Cytometry**
Flow cytometry reveals other characteristics of cells such as the size, shape and presence of tumor markers on the cell surface. For this test, cells are tagged with a fluorescent dye and placed in a liquid. A beam of light is passed through the cells, and the scattering of the light reveals the characteristics of the cells. It is an essential analysis in the diagnosis of acute leukemia.