In addition to lymphomas, vascular tumors represent the most common neoplasms of the spleen. Littoral cell angiomas are benign vascular tumors originating from the littoral cells lining the splenic sinuses. In this report, we describe the case of a 63-year-old patient who developed night sweats 16 months after renal transplantation. Diagnostic workup showed multiple splenic masses believed to represent lymphoma infiltration to the spleen. Lymph nodes and bone marrow were unaffected, and diagnostic splenectomy was performed. Histological examination of the pathological specimen from the splenectomy specimen showed multiple littoral cell angiomas of the spleen. We recommend that physicians involved in the area of organ transplantation, especially kidneys, remain alert for other rarer splenic lesions in transplant recipients than posttransplantation lymphoma. More specific tools need to be developed to aid in the differential diagnosis of splenic masses to avoid splenectomy in patients with littoral cell angiomas.