A patient has a normal white blood count, a moderately high platelet count, and mild anemia. The differential shows immature granulocytes, nucleated red cells, and teardrop-shaped red cells. Which of the following is most likely?

Question

Quizplus · Accepted Answer

The combination of immature granulocytes, nucleated red cells, and teardrop-shaped red cells suggests a myeloproliferative disorder with bone marrow fibrosis, which is characteristic of primary myelofibrosis. Polycythemia vera would typically show elevated red cell counts, while chronic myelogenous leukemia would show elevated white cell counts with immature myeloid cells. Essential thrombocythemia would show primarily elevated platelet counts, without the presence of immature granulocytes or nucleated red cells.

A Patient Has a Normal White Blood Count, a Moderately