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27 Oct 2025#morphology-monday#only-cells#white-cells

Morphology Monday | Case MM251027

This week’s case comes from a 59-year-old male who presented to the Emergency Department with fatigue, shortness of breath, and spontaneous bruising that had developed over several weeks. Initial blood tests revealed a markedly elevated white blood cell count, prompting urgent haematology review.

The laboratory investigations showed:

  • Full blood count: WBC = 168 × 10⁹/L

  • Flow cytometry: CD34– CD45+ CD117+ HLA-DR– CD13+ CD15– CD16– CD7– CD19– CD33+ CD64+ CD14– CD56– CD71+ CD123+ CD38+

  • Molecular results:

    • NPM1: Mutated

    • FLT3 ITD: Detected

    • t(8;21) and inv(16): Not detected

Blood film images from the patient are shown below:

Blood film from this case with many blast cells and smear cells across the field

Blood film from this case with numerous blast cells, clumps of blasts and smear cells

Low-power blood film from this case with many blast cells, several in clusters

What do you make of these results, and what do you see on the blood film? Feel free to follow the discussion on LinkedIn and Twitter/X.