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Low power photomicrograph (Image A) reveals infiltration of spleen by aggregates of macrophages. On high power (Image B), macrophages have abundant, fibrillary cytoplasm with characteristic wrinkled tissue paper appearance and small, eccentric nuclei (“Gaucher” cells). Typically, fibrillary cytoplasm of Gaucher cells show PAS positivity. CD68 immunostain and Iron stain also highlight these cells. Often, similar looking cells (Pseudo-Gaucher cells) are seen in hematologic abnormalities like CML, Hodgkin lymphoma and Multiple Myeloma.