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Acanthocytes have 3-20 thorn-like projections (often with knobby ends) irregularly spaced around the cell. Since these cells have lost their discoid shape, they are frequently smaller than normal and have little or no central pallor. The largest percentage, 50-100% of circulating red cells, can be seen in the rare condition, abetalipoproteinemia (hereditary acanthocytosis). Acanthocytes are indicated by the arrows in the image on the right.