Diagnosis

To diagnose hairy cell leukemia, your doctor may recommend:

• Physical exam. By feeling your spleen — an oval-shaped organ on the left side of your upper abdomen — your doctor can determine if it's enlarged. An enlarged spleen may cause a sensation of fullness in your abdomen that makes it uncomfortable to eat.

  Your doctor may also check for enlarged lymph nodes that may contain leukemia cells.

• Blood tests. Your doctor uses blood tests, such as the complete blood count, to monitor the levels of blood cells in your blood.

  People with hairy cell leukemia have low levels of all three types of blood cells — red blood cells, white blood cells and platelets. Another blood test called a peripheral blood smear looks for hairy cell leukemia cells in a sample of your blood.

• Bone marrow biopsy. During a bone marrow biopsy, a small amount of bone marrow is removed from your hip area. This sample is used to look for hairy cell leukemia cells and to monitor your healthy blood cells.
• Computerized tomography (CT) scan. A CT scan shows detailed images of the inside of your body. Your doctor may order a CT scan to detect enlargement of your spleen and your lymph nodes.

Careful analysis of hairy cell leukemia cells in your blood and bone marrow samples may reveal certain genetic and chemical changes that give your doctor an idea of your prognosis and play a role in determining your treatment options.