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Bone marrow smears stained with Wright–Giemsa showed a predominance of medium-to-large lymphoblasts with a high nuclear-to-cytoplasmic ratio, round to mildly irregular nuclear contours, and coarse chromatin. The cytoplasm was scant to moderately basophilic. A subset of blasts exhibited characteristic hand-mirror cell morphology, defined by a thin, elongated, lightly basophilic cytoplasmic tail clearly separated from the nuclear mass, resulting in a markedly asymmetric cellular contour. No Auer rods or cytoplasmic granules were identified.