Physical Examination 
• Enlarged lymph nodes in the neck, above the clavicles, under the arms or in the groin.
• Skin breakdown from scratching (excoriation) over most of the body because of itching.
• Fluid around the lungs (pleural effusion). 
• Liver or spleen enlargement.
• Abdominal mass. 
• Areas of bony tenderness. 

Blood and Other Tests 
• Complete blood count, including erythrocyte (red cell) sedimentation rate.
• Blood chemistries. These may be abnormal because of the tumor or because of the involvement of bone, the
  kidneys or liver.

Imaging 
• Chest x-ray may show masses within the chest, direct involvement of the lung or a pleural effusion.
• CT scan of the chest, abdomen and pelvis to look for enlarged lymph nodes or the involvement of the liver or
  spleen.