RBC
Membrane
Peripheral
Blood Smear
Normal Liver
Normal Lipid Bilayer
Normocytes
Cirrhotic Liver
Excess Cholesterol
in Outer Leaflet
Leptocytes
Organ
Enlarged Spleen
Depleted of Surface
Membrane Lipids
Acanthocytes
Key
Phospholipid with hydrophobic
head and hydrophilic tail.
Cholesterol with polar region and
non-polar hydrocarbon tail
Figure. Conversion of normal erythrocytes (normocytes) to thin, flat cells with
excess membrane (leptocytes), to spiculated cells (acanthocytes) whose excess
surface membrane has been removed by processing in the spleen. The changes in
the red blood cell membrane consist of accumulation of excess cholesterol in the
outer leaflet of the lipid bilayer, a process that renders the cells less fluid, followed
by loss of normal membrane architecture as the leptocyte’s excess membrane is
removed by the spleen. Note, permission for the normocytes and leptocytes is from:
http://pathy.med.nagoya-u.ac.jp/atlas/doc/atlas.html (”use at your own risk”). The
acanthocyte is from: http://www.hematologyatlas.com/ (permission required).