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HORIBA Chase the Case #45 - Myeloproliferative Disorder
A clinical case from China: a 46-year-old man who's hematology test results, performed by Yumizen H2500, suggest a possible myeloproliferative disorder.
June 2025 (PDF for print)
Patient Demography: Male aged 46, presented with retinal hemorrhage
Diagnosis: Features suggestive of Chronic Myeloid Leukemia
Microscopic Review: Neutrophils 50%, Lymphocytes 3%, Monocytes 5%, Eosinophils 1%, Basophils 3%, Promyelocytes 3%, Myelocytes 16%, Metamyelocytes 19%, occasional n RBC seen.
Other Test: Molecular and cytogenetic reports under process
How Yumizen Can Assist: On the DIFF scattergram, we observe a population corresponding to immature myeloid cells, reflected by high IMG and LIC values. The matrix shows an overlap between the neutrophils and monocytic threshold, indicating a high turnover of immature myeloid cells, consistent with high IMM (dysplasia associated with underlying bone marrow changes). This is due to the dysplasia noted on the WBC differential. The population is situated between the granulocytic-IMG and IMM, with high LIC correlating with the presence of myelocytes, metamyelocytes and promyelocytes seen on microscopy. The presence of basophils on microscopy with a left shift of myeloid cell series, suggests the possibility of a myeloproliferative disorder.
Microscopic examination of peripheral blood smear reveals a marked leukocytosis with a bimodal distribution of granulocytes, means there's an increase in the total number of white blood cells, including immature (metamyelocytes, myelocytes and promyelocytes) and mature granulocytes which are segmented neutrophils. Basophils are also seen elevated.
This clinical case has been provided by a laboratory in China.
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