Basophilic stippling: a lead to the diagnosis.

A44-year-old male presented with chronic abdominal pain that prompted multiple previous hospitalizations with negative assessments. The patient had a past history of moderate alcohol consumption but none in the past 20 years. There was no occupational exposure. Laboratory tests showed microcytic anemia (hemoglobin 6.6 mg/dL, mean corpuscular volume 66.8 fL) with normal iron studies and basophilic stippling on the peripheral smear (panel A). Further history disclosed a retained bullet fragment in his right thigh 2 years previously. Radiographic views of his right thigh affirmed several metallic bullet fragments and posttraumatic soft tissue calcification and ossification. Computed tomography with 3-D reconstruction (panel B) showed a large calcified mass of the thigh, consistent with a complex hematoma.