LAUSR

The study present a case of splenic lymphoma in a middle-aged male, showing up with abdominal pain, weight loss and recurrent oral candidosis. Blood test revealed remarkable leukocytosis, anemia and thrombocytopenia. Abdominal ultrasound showed marked splenomegaly with multiple hyperechogenic lesions. Contrast enhanced ultrasound (CEUS), performed on the lower pole of the spleen, showed a lesion lightly hypoenhanced in the arterial time, with progressive washout and marked hypoenhancement in the late phase, raising the suspicion of a malignant pathology. MRI results were consistent with a high suspicion of splenic malignancy, a possible lymphoid infiltration. The peripheral blood smear revealed lymphocytosis with villous lymphocytes, a variant form of hairy cell leukaemia. Iliac crest bone marrow biopsy confirmed the diagnosis. Our aim behind highlighting the topic is to underline the role of CEUS in identifying a malignant lesion, promptly leading us to further hematological investigation.