I had a look and saw:
Myelocytes (with peri-nuclear halo)
Rbc (in order of priority)
I felt that this was possibly a case of sepsis (or Jordan's anomaly) in someone with a haemolytic condition. And I said that “without more information any further speculation is frankly guesswork”.
The final report said “It is certainly possible that the polychromasia and nucleated cells reflect a bone marrow response to red cell destruction. However, the abnormal erythrocyte forms present are not typical of red cell fragmentation, membrane disorder, or abnormal haemoglobin. We should therefore consider that bone marrow infiltration (particularly a myelodysplastic syndrome) may be present causing the expulsion of immature and maturing”…
“This is a patient with chronic myelomonocytic leukaemia who had experienced a deterioration in his health following an infection. The features have been described in the narrative, but the diagnosis is not simple. Without full knowledge of the number of monocytes, and a review after the infection is resolved, it is not possible to be fully confident that this is chronic myelomonocytic leukaemia. However, the extensive dysplastic features present should allow a diagnosis of probably underlying myelodysplasia; and a possible diagnosis of CMML could be suggested”.
I spotted the salient features which could equally well be applied to what I thought it was as well as what it supposedly was.