Learner decision

Reconstruct the granulocyte sequence before interpreting the case. A metamyelocyte follows the myelocyte and precedes the band, so a segmented neutrophil cannot become a myeloblast. The sequence makes the nuclear transition testable rather than memorized.

For this film, bands and rare metamyelocytes fit a left shift. No blasts are seen. If blasts or an unassignable immature population were present, morphology alone would not establish lineage and the laboratory's escalation path would apply.

Choose the description that reports what the method supports without naming disease. Keep the analyzer flag, calculation, smear finding, and local policy distinct. Release a morphology comment only after required review and communication steps are complete.