Cardiac Angiosarcoma With Lung Metastasis Presenting as Granuloma-Like Lesions: One Case Report and Literature Review.

Metastatic pulmonary angiosarcoma exhibits highly heterogeneous clinical, imaging and pathological features, with an extremely poor prognosis. This case report describes a 30-year-old woman who presented with recurrent hemoptysis and multiple pulmonary nodules with exudative changes in the lung, pathologically resembling granulomatous lesions and eventually confirmed as primary cardiac angiosarcoma with pulmonary metastasis. Twenty-two cases of metastatic pulmonary angiosarcoma from the literature were reviewed. For cases with recurrent hemoptysis, multiple pulmonary nodules or thin-walled cysts and 'halo sign' or ground-glass opacities, metastatic pulmonary angiosarcoma should be highly suspected. Histopathology remains the gold standard for diagnosis. Early biopsies or small biopsy specimens carry a risk of false negativity; adequate tissue samplings are essential to improve diagnostic accuracy.