Diagnosis of B-cell prolymphocytic Leukemia and Hairy Cell Leukemia

Many tests are performed to find or diagnose cancer. They also do tests to see if cancer has spread to another part of the body from where it began. If this happens, it is called metastasis. For instance, imaging tests can represent if cancer has spread. Imaging tests show pictures of the body from the inside. Doctors can also do tests to learn which treatments would work best.

A biopsy is the sure short way for the doctor to know if an area of the body has cancer for most types of cancer. In a biopsy, the doctor takes a small tissue sample for testing in a laboratory. The doctor may suggest other tests if a biopsy cannot help diagnose.

The doctor may consider given factors when choosing a diagnostic test:

  • Your signs and symptoms
  • The age and general health status
  • The type of cancer suspected
  • The result of earlier medical tests

The following tests can be used to diagnose PLL and HCL:

  • Blood tests- The diagnosis of PLL or HCL begins with a blood test, called a complete blood count (CBC). A CBC measures the numbers of different cells in a person’s blood. If the blood contains many white blood cells, a type of B-cell leukaemia may be suspected. However, patients with HCL often have deficient levels of white blood cells.
  • Bone marrow aspiration and biopsy- These two procedures are similar and often done simultaneously to evaluate the bone marrow, which is the fatty, spongy tissue found inside larger bones. Bone marrow has both a liquid and a solid part. A bone marrow aspiration takes a sample of the fluid using a needle. A bone marrow biopsy removes a small quantity of solid tissue using a needle.

A pathologist then reviews the samples in a lab. Pelvic bone located by the hip is a common site for bone marrow aspiration and biopsy. Doctors generally give a medication called “anaesthesia” beforehand to numb the area. Anaesthesia is a medication that blocks the awareness of pain.

  • Molecular testing – Your doctor may recommend running laboratory tests on a bone marrow sample to identify specific genes, proteins, and other factors unique to the leukaemia.
  • Immunophenotyping examines antigens, a specific type of protein, on the surface of the leukaemia cells. Immunophenotyping allows the doctor to confirm the exact type of leukaemia.
  • Cytogenetics examines the leukaemia cells for abnormalities in the long strands of genes called chromosomes. It helps the doctor confirm the diagnosis and may help to determine the person’s chance of recovery.

These tests will also help the doctor decide if your treatment options include targeted therapy.

  • Computed tomography (CT or CAT) scan – A CT scan takes pictures of the body from inside using x-rays taken from different angles. A computer then combines these pictures into a detailed, 3-dimensional image showing abnormalities or tumours. A CT scan can be used to determine the tumour’s size. Occasionally, a specific dye called a contrast medium is given before the scan to provide detail on the image. This dye can be delivered into a patient’s vein or provided as a pill or liquid to swallow. 

Positron emission tomography (PET) or PET-CT scan creates images of organs and tissues present inside the body. A small quantity of a radioactive substance is injected into the patient’s body which is taken up by cells using the most energy. The cancer cells which use energy actively take up the radioactive substance, and the scanner then spots this substance to produce images of the inside of the body. However, the radioactivity in the substance is significantly less harmful to patients. A scanner then detects this radioactive substance to produce images of the inside of the body. A PET scan is occasionally used to help diagnose and evaluate PLL and HCL.