This is a markedly enlarged spleen (the ruler is 15 cm long). Such massive splenomegaly is usually indicative of some myeloproliferative disease such as chronic myelogenous leukemia or myelofibrosis. There are subcapsular yellow-tan infarcts. Congestive splenomegaly (as with portal hypertension in cirrhosis of the liver) is unlikely to increase the size of the spleen over 800 gm. A spleen >1000 gm suggests a myeloproliferative, lymphoproliferative, or hematopoietic disorder.

---