A 57 year-old male with fatigue and LUQ heaviness

A 57 year-old male presents with fatigue and left upper quadrant heaviness. His white blood cell count is 110 x 109/L, and his hemoglobin is 8 g/dL. A bone marrow biopsy is performed, and in addition to a marked increase in neutrophils and precursors, a rare cell such as the one depicted here is present.

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