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4 Aug 2025#morphology-monday#only-cells#white-cells

Morphology Monday | Case MM250804

We're back with another Morphology Monday case! This week's case comes from a 69 year old male presenting with a increasing fatigue and back back over the past several months. He has also experiences recurrent infections recently.

A full blood count was requested and the results were:

  • WBC: 4.2 ×10⁹/L

  • RBC: 2.85 ×10¹²/L

  • Hb: 92 g/L

  • HCT: 0.27

  • MCV: 94 fL

  • MCHC: 341 g/L

  • Platelets: 118 ×10⁹/L

A blood film was made for review. Here are some of the images:

Blood film from this case with two cells with eccentric nuclei and basophilic cytoplasm, and red cells forming rouleaux

Blood film from this case with one cell with an eccentric nucleus and red cells stacking into rouleaux

Blood film from this case with three cells with eccentric nuclei and a neutrophil, and red cells forming short rouleaux

Blood film from this case with a single cell with an eccentric nucleus among the red cells

Blood film from this case with four cells with eccentric nuclei, including a binucleate one

Blood film from this case showing two circulating cells with eccentric nuclei

The biochemistry results showed:

  • Creatinine: 152 µmol/L

  • Corrected Calcium: 2.78 mmol/L

  • Total Protein: 96 g/L

  • Albumin: 28 g/L

What do you think is wrong with the patient?