Diagnostic Utility of Contrast-Enhanced Ultrasound and Multimodal Imaging in Splenic Angiosarcoma: A Pathologically...

Splenic angiosarcoma is an extremely rare and highly aggressive malignant vascular tumor with nonspecific clinical manifestations and variable imaging appearances. We report a case of a middle-aged male presenting with progressive upper abdominal discomfort and a large splenic mass accompanied by cardiophrenic lymphadenopathy and peritoneal involvement. Ultrasound, contrast-enhanced ultrasound (CEUS), computed tomography (CT), and magnetic resonance imaging (MRI) demonstrated aggressive imaging features highly suggestive of malignancy. Ultrasound-guided biopsies of both the splenic lesion and cardiophrenic lymph nodes revealed malignant vascular proliferation with spindle and epithelioid morphology, a high Ki-67 proliferation index, and diffuse endothelial marker positivity, confirming the diagnosis of splenic angiosarcoma. This case highlights the diagnostic value of CEUS combined with multimodal imaging in the early recognition and accurate diagnosis of malignant splenic vascular tumors.