Hairy Cell Leukemia

Healthcare providers will ask when your symptoms started and take a medical history, including whether you have infections that keep coming back. They’ll also do a physical examination. They may feel (palpitate) your lymph nodes, spleen and liver for signs of swelling.

They may refer you to a hematologist or medical oncologist for more tests that will lead to a diagnosis. These tests may include:

• Complete blood count (CBC) with differential: This test measures the number of red and white blood cells and platelets. The differential measures the different types of white blood cells.
• Peripheral blood smear: Pathologists examine blood cells under a microscope, looking for abnormal cells that have the tiny hair-like projections that give hairy cell leukemia its name.
• Bone marrow aspiration and bone marrow biopsy: These tests detect abnormal cells in your bone marrow.
• Computed tomography (CT) scan: CT scans make detailed pictures of areas inside your body. Your provider may order this test or an abdominal ultrasound to check the size of your spleen, liver and lymph nodes.
• Flow cytometry: Pathologists check your blood and bone marrow for signs of abnormal hairy cells. They check the cells’ size and shape and look for tumor markers. Tumor markers may refer to proteins that cancerous cells make.