Opening laboratory problem

A lavender-top K2EDTA specimen has a WBC of 14.2 × 10^9/L and an immature-granulocyte flag, an analyzer alert that signals a population the instrument classifies as immature granulocytes and requires review under validated criteria. The automated differential reports 78% neutrophils. The question is whether the film contains a recognizable maturation pattern or a cell population that needs a different path.

A CBC analyzer measures cell-associated signals and calculates a differential. The result may indicate altered marrow output, but it does not name the cause. A manual film review follows the laboratory's medical-director-approved criteria, not a universal flag threshold.

Start with what is visible on the film: a small band population and rare metamyelocytes, with no blasts. Those cells have a place in a normal granulocyte sequence. Release the routine result through the local review process and describe morphology with the laboratory's standardized terms.