Illustration of Case 1. (A, B) A peripheral blood smear, showing leukocytosis with neutrophil predominance and only a rare myelocyte (upper center of image A). Neutrophils exhibit normal morphology. (C) The bone marrow aspirate smear shows predominance of granulocytic forms, without significant dysplasia. (D) The bone marrow biopsy is markedly hypercellular with an elevated myeloid to erythroid ratio and intact granulocytic maturation. Megakaryocytes are not increased, do not cluster, and include some small forms.