Lymphoma: This is a common cause of hepatosplenomegaly, anemia, and thrombocytopenia due to bone marrow infiltration and splenic sequestration. Lymphoma can lead to cytopenias through various mechanisms, including marrow replacement and immune-mediated destruction.

Chronic Lymphocytic Leukemia (CLL): CLL can cause anemia and thrombocytopenia due to bone marrow infiltration and immune-mediated mechanisms. Hepatosplenomegaly is common in CLL due to lymphoid infiltration.
Hodgkin Lymphoma: Similar to non-Hodgkin lymphoma, Hodgkin lymphoma can cause hepatosplenomegaly and cytopenias through marrow involvement and splenic sequestration.
Myeloproliferative Neoplasms (MPN): Conditions like primary myelofibrosis, essential thrombocythemia, and polycythemia vera can lead to hepatosplenomegaly. While they typically present with elevated blood cell counts, advanced stages or transformation can result in cytopenias.
Chronic Liver Disease: Liver cirrhosis can cause splenomegaly (leading to thrombocytopenia due to splenic sequestration) and anemia due to various factors, including decreased liver function affecting nutrient and vitamin metabolism.

Hairy Cell Leukemia: A rare form of leukemia that can cause significant splenomegaly and pancytopenia. It's crucial to consider due to its specific treatment options and potential for severe infections.
Sickle Cell Disease with Splenic Sequestration: While more commonly associated with hemolytic anemia, sickle cell disease can lead to episodes of splenic sequestration, causing acute drops in hematocrit and platelet count, along with hepatosplenomegaly.
Tuberculosis: TB can cause hepatosplenomegaly, anemia, and thrombocytopenia, especially in endemic areas. It's a diagnosis that could be easily missed but has significant implications for treatment.

Gaucher's Disease: A lysosomal storage disorder that can lead to hepatosplenomegaly and cytopenias due to marrow infiltration by Gaucher cells.
Niemann-Pick Disease: Another lysosomal storage disorder that can cause hepatosplenomegaly and cytopenias.
Primary Splenic Neoplasms: Rare tumors originating in the spleen, such as lymphangiomas or hemangiomas, which can cause localized symptoms and cytopenias due to splenic sequestration.
Kala-Azar (Visceral Leishmaniasis): A parasitic infection that can cause hepatosplenomegaly, anemia, and thrombocytopenia, particularly in endemic areas.