Acanthocytes (RBCs) with multiple thorny, spike-like projections irregularly distributed around the cellular membrane.

Have few spicules, unlike echinocytes.

Prevalent in abetalipoproteinemia and spur anemia.

In abetalipoproteinemia, lipids are not absorbed in the small intestine and decreased plasma lipids alters the red blood cell membrane impairing its integrity.

Found in cirrhosis with associated hemolytic anemia, following heparin administration, in hepatic hemangioma, neonatal hepatitis, and postsplenectomy.