A Peripheral Blood Cell Morphology Case

An interestinc case from a blog for medical laboratory professionals

A 42-year-old male presents with fever and fatigue. A CBC shows the following:
Hgb 14.2 g/dL (normal = 13.5 – 17.5 g/dL), WBC 18 x 10⁹/L (normal = 4.5 – 11 x 10⁹/L) and Platelet count 320 x 10⁹/L (normal = 150 – 450 x 10⁹/L)
Differential: Neutrophils and precursors: 80%, Lymphocytes: 16%, Monocytes: 2.5%, Eosinophils: 1.4% and Basophils: 0.1%

A review of the blood smear shows a slight left shift in the neutrophil series, with occasional metamyelocytes and rare myelocytes present. Several cells similar to the one shown below are noted.

Which of the following is the most likely diagnosis?

A.  Acute myeloid leukemia
B. Chronic myeloid leukemia
C. Bacterial infection
D. Viral infection
E. Parasitic infection

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Source:  A blog for medical laboratory professionals