Chronic Myeloid Leukemia: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further:
    • Inspection (viewing).
      • Skin, mucous membranes, and sclerae (white part of the eye) [accompanying symptom of chronic phase: night sweats].
      • Abdomen (abdomen)
        • Shape of the abdomen?
        • Skin color? Skin texture?
        • Efflorescences (skin changes)?
        • Pulsations? Bowel movements?
        • Visible vessels?
        • Scars? Hernias (fractures)?
    • Inspection and palpation (palpation) of the lymph node stations (cervical, axillary, supraclavicular, inguinal).
    • Auscultation (listening) of the heart [due topossible secondary disease: cardiomyopathy (heart muscle disease)].
    • Auscultation of the lungs [due topossible sequelae: pulmonary insufficiency (inability of the lungs to perform adequate gas exchange)]
    • Examination of the abdomen (abdomen)
      • Percussion (tapping) of the abdomen
        • Meteorism (flatulence): hypersonoric tapping sound.
        • Attenuation of tapping sound due to enlarged liver or spleen, tumor, urinary retention?
        • Hepatomegaly (liver enlargement) and/or splenomegaly (spleen enlargement): estimate liver and spleen size.
      • Palpation (palpation) of the abdomen, etc., with an attempt to palpate the spleen.
        • [Leading symptom of chronic phase: splenomegaly; accompanying symptom of chronic phase: upper abdominal pain]
        • [Symptom of accelerated phase: increasing splenomegaly]
    • Inspection of the genital [due todifferential diagnosis: other forms of leukemia, e.g., acute lymphoblastic leukemia (ALL), which is associated with painless, usually unilateral, swelling of the testis].
  • If necessary, urological / nephrological examination [due topossible secondary disease: renal insufficiency / uremia (kidney weakness / kidney failure)]
  • Health check (as an additional follow-up measure).

Square brackets [ ] indicate possible pathological (pathological) physical findings.