Acanthocytes and echinocytes (burr cells, crenated cells) are erythrocytes with multiple projections that can be distinguished by their appearance on a peripheral blood smear.
Parameters:
(1) number of projections
(2) distribution of projections
(3) length of the projections
(4) shape of projections
(5) central pallor
(6) diameter
Parameter
Acanthocyte
Echinocyte
number of projections
2 - 20
10 - 30
distribution
irregular
even
length of the projections
variable (some short, some long)
short, relatively uniform
shape of projections
pointed or knobby end; may have narrow base
blunt or pointed
central pallor
absent
present
diameter of cell
smaller than normal
smaller than normal to normal
where:
• If the classification is in doubt, the presence or absence of central pallor can be used to decide (assuming you care).
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