A patient has a normal white blood count, a moderately high platelet count, and mild anemia. The differential shows immature granulocytes, nucleated red cells, and teardrop-shaped red cells. Which of the following is most likely?
a. Polycythemia vera
b. Chronic myelogenous leukemia
c. Primary myelofibrosis
d. Essential thrombocythemia
ANS: C
These findings would all be characteristic of primary myelofibrosis. Polycythemia vera and chronic myelogenous leukemia would both be expected to have an elevated white count. The platelet count is markedly increased in essential thrombocythemia.
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