"Case 2"
Case 2

žCase 2
History:
51 year old male.
Seen by local physician for routine preoperative exam prior to dental surgery. Found to have low hemoglobin and a large left upper quadrant mass.
Physical Exam:
Marked splenomegaly (subsequently confirmed by CT scan) extending from the left costal margin to just above the iliac crest. No other organomegaly

Slide 3

CBC
RBC 3.36 x 10[12]/L
HGB 10.9 g/dL
HCT 31.2 %
MCV 92.8 fL
MCH 32.4 pg
MCHC 34.9 g/dL
WBC 9.3 x 10[9]/L
N 14 %
L 15 abnormal cells 71 (shown)
PLT 59 x 10[9]/L

"Question"
Questions

What morphologic alterations are seen in this blood smear field?

What further laboratory studies, if any, are indicated?

What is the most likely diagnosis?