Aggressive B-cell Lymphoma Masquerading as Benign Epstein-Barr Virus (EBV)-Related Splenomegaly: An Analysis of Diagnostic Anchoring Bias.

We report a case involving a 52-year-old male who was initially diagnosed with Epstein-Barr virus (EBV)-related splenomegaly and subsequently identified as having an aggressive B-cell lymphoproliferative disorder. Despite multiple initial diagnostic tests yielding negative results, persistent clinical suspicion due to the worsening patient's condition warranted further investigation, ultimately establishing the correct diagnosis. This case underscores the diagnostic challenges in distinguishing benign viral-associated splenomegaly from underlying malignant lymphoproliferative disorders and highlights the importance of maintaining clinical vigilance when initial diagnostic findings are discordant with the clinical presentation.