Mantle cell lymphoma, blastoid variant, may present with spontaneous splenic rupture. The splenic white pulp in this case was diffusely replaced by sheets of large cells with irregular nuclei and one or more prominent nucleoli. Flow cytometry revealed a monoclonal B-cell population positive for CD5 and cyclin D1 and negative for CD10 and CD23. This is an aggressive tumor with poor prognosis.
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