The aspirate contained blood with blood-associated leukocytes and aggregates and individualized spindle cells (arrow). The cells displayed mild to moderate anisokaryosis and anisocytosis (Wright’s stain, 20x objective). Taken alone, these cytologic findings would have been inconclusive, just indicating mesenchymal cell proliferation, which could be reactive or neoplastic. However, with the history of red cutaneous masses and prior surgical removal of cutaneous hemangiosarcomas, a diagnosis of hemangiosarcoma was favored.
