Splenomegaly is a defining clinical feature of myelofibrosis, arising predominantly from extramedullary hematopoiesis as compensation for progressive bone marrow fibrosis.1 This pathological spleen enlargement is prevalent with more than one-third of patients presenting with a spleen palpable at least 10 cm below the left costal margin and nearly a quarter exhibiting splenic extension beyond 16 cm.2 Clinically, splenomegaly contributes to a significant symptom burden, including early satiety, abdominal discomfort, and pain, all of which can impair quality of life.