What are acanthocytes characterized by?

Acanthocytes are indeed characterized by multiple, irregular, club-shaped projections from the cell surface. These projections, also known as spicules or spikes, are unevenly distributed, giving acanthocytes their distinctive appearance. The irregular shape of these projections results from alterations in the lipid composition of the red blood cell membrane, often associated with conditions such as abetalipoproteinemia or liver disease.

This unique morphology contrasts with other abnormal red blood cell shapes, such as echinocytes, which have evenly distributed spine-like projections. The size of acanthocytes tends to be similar to that of normal red blood cells rather than being smaller, and they typically do not exhibit increased central pallor, as this feature pertains more to other types of cells affected by conditions like hypochromic anemia. Thus, the defining characteristic of acanthocytes is their irregular, club-shaped projections, making them easily identifiable under a microscope in pathological specimens.