Blood Cancer Diagnosis

Specialists at Houston Methodist are among the best worldwide in the diagnosis and treatment of blood cancers including leukemia, lymphoma and myeloma. Our testing methods and technologies are the among the most advanced in the nation, offering precision results to equip your health care team to create personalized treatment plans. 

Diagnosing Leukemia, Lymphoma & Myeloma

If you experience symptoms of blood cancer, your doctor may perform one or more diagnostic tests to confirm a diagnosis and determine the specific type and stage of the cancer. 

Medical History Review and Physical Exam

Your doctor will conduct a thorough review of your personal and family medical history to identify any hereditary risk factors. During a physical exam, your doctor will check you for swollen lymph nodes, abnormal bruising or other signs that may indicate blood cancer. 

Blood Tests

Blood tests can detect abnormalities in the blood, including red and white blood cell counts and platelets. Common blood tests include: 

 

• Blood smear – This test is used to examine the shape and size of blood cells under a microscope. 
• Blood chemistry tests – These tests are used to assess the levels of various chemicals and enzymes in the blood, which can indicate organ function and possible cancer spread. 
• Circulating tumor DNA – This is a novel test that can be used to detect circulating cancer cells related to your primary lymphoma. 
• Complete blood count (CBC) – A CBC measures the levels of red blood cells, white blood cells and platelets. 
• Flow cytometry – A type of blood test that can be used to detect abnormal cells that might suggest the presence of leukemia or lymphoma. 
• Kappa/lambda, serum protein levels – These blood tests are used to diagnose and monitor treatment response in patients with multiple myeloma. 

Imaging Tests

Imaging tests determine how far the disease has spread and whether treatment has been effective. Common imaging tests include: 

 

• Bone scans – These scans identify bone abnormalities or metastasis. 
• Chest X-rays – These X-rays identify abnormalities in the chest area, such as enlarged lymph nodes or tumors. 
• Computed tomography (CT) scans – CT scans provide detailed cross-sectional images of the body to detect the presence and spread of cancer. 
• Magnetic resonance imaging (MRI) – MRI uses magnetic fields to produce detailed images of organs and tissues. 
• Positron emission tomography (PET) scans – PET scans detect areas of high metabolic activity, which can indicate cancerous growth.

Bone Marrow Tests

Bone marrow tests are essential to diagnose and classify blood cancers.  

During a bone marrow aspiration, your doctor takes a sample of the liquid part of the bone marrow to test for cancer cells. 

During a bone marrow biopsy, your doctor takes a sample of the solid part of the bone marrow to obtain more detailed information about the bone marrow cells. 

Molecular Genetic Studies

Doctors use molecular genetic studies to identify specific genetic mutations or chromosomal abnormalities associated with blood cancers. 

A polymerase chain reaction (PCR) study amplifies DNA sequences and is used to detect genetic mutations. 

A fluorescence in situ hybridization (FISH) study is used to identify chromosomal abnormalities using fluorescent probes. 

Lumbar Puncture (Spinal Tap)

A spinal tap involves drawing a sample of cerebrospinal fluid (CSF) from the spinal canal to check for the presence of abnormal or cancerous cells. This test helps doctors determine if cancer has spread to the central nervous system.

Biopsy

For a biopsy, a surgeon removes a sample of tissue from a lymph node or tumor mass for microscopic examination. 

For an excisional biopsy, a surgeon removes the entire lymph node or tumor mass for detailed analysis. 

A lymph node biopsy is performed to diagnose lymphomas. A doctor studies the structure and characteristics of the lymph node cells for abnormalities. 

Sophie Hoelscher was in her 20s, recently engaged, planning a wedding and moving into a new house when she was diagnosed with bulky Hodgkin’s lymphoma. She received advanced treatment from her team of experts at Houston Methodist. “They saved my life here,” Sophie says.  Read Sophie’s Story ➝