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52 year old male with hyperleukocytosis, splenomegaly and weight loss is evaluated for suspected myeloproliferative neoplasm. Bone marrow aspirate shows myeloid hyperplasia with myelocyte bulge. A histiocyte with cytoplasm containing needle-like inclusions is observed (pseudo-Gaucher cell). RT-PCR revealed the presence of t(9;22)(q34;q11) BCR::ABL1 (M-bcr, p210).