18 Basophilic Stippling

Michelle To and Valentin Villatoro

Images show peripheral blood smears with basophilic stippling in the red blood cells (indicated by arrows). From MLS Collection, University of Alberta.

Image 1: 100x oil immersion. https://doi.org/10.7939/R3G15TS2N

Image 2: 100x oil immersion. https://doi.org/10.7939/R3RJ4993X

Image 3: 100x oil immersion. https://doi.org/10.7939/R3J960R3H



Multiple dark blue-purple granules that are distributed throughout the red blood cell. Granules can appear coarse, fine, round, and/or irregularly shaped, and are present in numerous numbers.1,2  Typically, only coarse basophilic stippling is reported.


Inclusion composition:1-3

Aggregates of ribonucleic Acid (RNA)


Associated Disease/Clinical States: 1,2

Lead toxicity


Abnormal heme synthesis


1. Landis-Piwowar K, Landis J, Keila P. The complete blood count and peripheral blood smear evaluation. In: Clinical laboratory hematology. 3rd ed. New Jersey:  Pearson; 2015. p. 154-77.

1. Rodak BF, Carr JH. Variations in shape and distribution of  erythrocytes. In: Clinical hematology atlas. 5th ed. St. Louis, Missouri: Elsevier Inc.; 2017. p. 93-106.

3. Bain BJ. Morphology of blood cells. In: Blood cells: a practical guide [Internet]. 5th ed. Chichester, UK: John Wiley & Sons, Ltd; 2015 [cited 2018 Jul 10]: 67-185. Available from: http://doi.wiley.com/10.1002/9781118817322


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Basophilic Stippling Copyright © 2019 by Michelle To and Valentin Villatoro is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.

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