Splenic lymphoid hyperplasias versus lymphomas/leukemias. A diagnostic guide

An accurate diagnosis of a lymphoid infiltrate in the spleen is based on several essential factors. 1. The spleen must be well fixed and the sections of high technical quality. 2. The pathologist has to be congnizant of the predominant distributional features, whether primarily in the white or in the red pulp, of the various lymphoid infiltrates that result in splenomegaly. 3. A differential diagnostic scheme also should be based on the predominant histologic pattern and cell type. 4. Immunophenotypic and occasionally molecular genetic studies are imperative for refinement and verification of the histologic diagnosis.