Cutaneous angiosarcoma is a rare but aggressive vascular malignancy that can present a diagnostic challenge due to a wide variety of clinical appearances and histologic features. Final diagnosis traditionally is yielded by corroborating the histologic and immunohistochemical findings with the clinical presentation; however, a histologic feature known as “fish in the creek,” which consists of free-floating or tufted pleomorphic spindle cells within the vascular lumen, may be an additional diagnostic clue. In this study, we aimed to determine the diagnostic utility of this finding in cutaneous angiosarcoma. Our results suggest that “fish in the creek” has the potential to be an additional useful diagnostic tool for an otherwise challenging and deceptive malignancy.
April 4, 2018