A schistocyte is a fragment of a red blood cell. Normal red blood cells have a circular and regular shape, and have a "central pallor" or lighter spot as the cell is flatter in the middle (similar in shape with a donut, but with a thin layer in the center rather than a hole) However, they can also be caused by hemolytic anemia, artificial heart valves, DIC and thrombotic thrombocytopenic purpura, as well as similar diseases.