Hepatosplenomegaly is quite commonly seen in mantle cell lymphoma (MCL). About 30% to 60% of patients with MCL have massive splenomegaly and some of these patients may present with pathologic rupture of spleen. On occasion, MCL presents with splenomegaly and peripheral blood involvement with no generalized lymphadenopathy. Such cases may be difficult to distinguish from lymphoid leukemias. Grossly, the spleen has a micronodular appearance due to enlargement of white pulp nodules as seen here. It may be difficult to distinguish from follicular lymphoma macroscopically.