Guided case: abnormal WDF evidence

The specimen was collected at 08:10, received at 08:25, and analyzed at 08:40 in a modeled Sysmex XN-series WDF/WNR workflow. Results are WBC 14.2 × 10^3/µL, RBC 3.25 × 10^6/µL, hemoglobin 9.8 g/dL, hematocrit 29.5%, MCV 90.8 fL, MCH 30.2 pg, MCHC 33.2 g/dL, and platelets 165 × 10^3/µL. Displayed intervals are illustrative teaching intervals, not universal reference intervals.

The WDF scattergram has an atypical cluster near the lymphocyte region and the report has an NRBC-related review flag. WDF identifies a differential-classification concern; it does not count NRBCs for WBC correction. The WNR channel separately enumerates WBC and NRBC events. In this case, the displayed WBC is the WNR-derived, NRBC-corrected WBC; no manual WBC correction formula is applied.

A peripheral smear is reviewed under the validated local rule and shows 12 NRBC per 100 WBC and occasional immature granulocytes. The smear findings establish the morphology: NRBCs have a dense nucleus with surrounding erythroid cytoplasm, and immature granulocytes have less-condensed nuclear chromatin than segmented neutrophils. These findings support the documented review outcome, not a diagnosis.