All are true regarding Myelofibrosis EXCEPT

(D) Absence of splenic enlargement # Teardrop-shaped red blood cells indicative of membrane damage from passage through the spleen, a nucleated red blood cell, and immature myeloid cells indicative of extramedullary hematopoiesis are noted. This peripheral blood smear is related to any cause of extramedullary hematopoiesis.> A blood smear will show the characteristic features of extramedullary hematopoiesis: teardrop-shaped red cells, nucleatec red cells, myelocytes, and promyelocytes; myeloblasts may also be present.> Anemia, usually mild initially, is the rule, while the leukocyte and platelet counts are either normal or increased, but either can be depressed.> Mild hepatomegaly may accompany the splenomegaly but is unusual in the absence of splenic enlargement; isolated lymph- adenopathy should suggest another diagnosis.> Both serum lactate dehydrogenase and alkaline phosphatase levels can be elevated.> Exuberant extramedullary hematopoiesis can cause ascites; portal, pulmonary, or intracranial hypertension; intestinal or ure eral obstruction; pericardial tamponade; spinal cord compression; or skin nodules.> Splenic enlargement can be sufficiently rapid to cause splenic infarction with fever and pleuritic chest pain.> Hyperuricemia and secondary gout may ensue.