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An 85-year-old woman presented with weakness and abdominal pain. Evaluation revealed pancytopenia, peripheral blood lymphocytosis, and massive splenomegaly. A splenectomy was performed. The 2,227 g spleen had cut surfaces that were dark red-brown and homogeneous. Flow cytometric immunophenotyping revealed a CD45 bright lymphoid population that expressed B cell antigens, FMC7, CD11c, and CD103. CD5, CD10, and CD23 were not expressed.
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• Chronic myeloid leukemia
• Hairy cell leukemia
• Large B-cell lymphoma
• Mantle cell lymphoma
• Small lymphocytic lymphoma/chronic
• Splenic marginal zone lymphoma
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