This patient’s blood film shows many hypergranulated promyelocytes (above and below) along with distinctive bilobed or ‘butterfly’ shaped blast cells. The white blood cell count is 35.42×10⁹, haemoglobin 80g/L and a marked thrombocytopaenia with a platelet count of 26×10⁹. These are reflected on the blood film. The thrombocytopaenia is genuine and no clumps were seen on the film. A manual differential count showed majority of the cells present were immature with very few mature cells.

There is polychromasia also present.
_____
Images: Personal photography.