This week’s Morphology Monday case is from a patient who went to their GP and presented with fatigue and shortness of breath. A full blood count was requested as part of the initial workup.

FBC results:

• WBC: 7.60 ×10⁹/L
• RBC: 1.44 ×10¹²/L
• Hb: 60 g/L
• MCV: 121.5 fL
• MCH: 41.7 pg
• Platelets: 240 ×10⁹/L

Additional lab results:

• Vitamin B12: 90 ng/L (Low; reference range: 180–914 ng/L)
• Serum Folate: 7.4 µg/L (Normal; reference range: 4.6–18.7 µg/L)
• LDH: 1140 IU/L (Elevated; reference range: 125–220 IU/L)

Given the red cell indices and the biochemistry profile, what are your differentials?