"Case 5"
Case 5

Case 5
History:
39 year old female.
History of fibrocystic breast disease. Seen for routine work-up prior to breast biopsy.
Physical Exam:
Moderate splenomegaly.
No other organomegaly

Slide 3

CBC
RBC 4.28 x 10[12]/L
HGB 13.4 g/dL
HCT 41.2 %
MCV 96.3 fL
MCH 31.3 pg
MCHC 32.5 g/dL
WBC 133.6 x 10[9]/L N seg 56 % N band 15 N meta 13 N myelo 4 N pro 3 L 3 M 4 E 1 B 1
PLT 417 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?