A 48 year old male initially presented with spinal cord compression and a paraspinal mass. He received local radiation therapy. Eight months later he developed generalized lymph node involvement and pancytopenia. Bone marrow and lymph node biopsies showed T-cell / histiocyte rich large B-cell lymphoma. He received R-ESHAP, with partial response, followed by R-MINE. Splenomegaly was noted. He underwent splenectomy. Spleen weighed 2000 grams.