Question : Comment upon this blood film of a male patient aged 21 years‚ who complains of an acutely swollen and painful knee joint following a recent accident. Hb = 12.3g/dl.‚ red cells 3.76x10^9‚ white cells 140x10^9/l.‚ platelets 737x10^9.
Answer: There are many neutrophils and granulocyte precursors. The latter are mostly myelocytes but there are a few earlier forms‚ which have a high nuclear to cytoplasmic ratio and even at this magnification show prominent nucleoli. This is an example of chronic myeloid leukaemia presenting at an atypically early age. The red cells are not well shown in this picture but you can calculate the MCH
