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Case Study, continued: Poikylocytosis and Basophilic Stippling

In the images to the right, the poikilocytosis present includes teardrop-shaped erythrocytes, schistocytes, and target cells. In addition, macrocytes are present, two of which (one in each field) have coarse basophilic stippling. The stippling may represent abnormal hemoglobin synthesis. These stippled erythrocytes remain in circulation in the absence of pitting by a spleen.