What the pattern supports and what it cannot establish

This case supports a dimorphic distribution because a representative monolayer shows two discernible populations and the analyzer histogram has two aligned volume peaks. An in-range MCV does not overturn that conclusion because it is an average. Low aggregate MCHC supports increased pallor somewhere in the population, not a specific subpopulation.

The case does not establish a cause of dimorphism. Polychromasia and 2.8% reticulocytes are concordant observations, not a quantified marrow-response conclusion without ARC and local convention. A laboratory must standardize reportable terms, grading, interobserver consistency, smear-review criteria, and escalation.

When film and analyzer agree, release approved dimorphic morphology. When they do not agree, document the discrepancy and follow the interference pathway to verification, recollection, suppression, consultation, or escalation.