This 35 year old woman had a long-standing solitary mass on her ankle. It was mildly painful. It was biopsied as a possible cyst or glomus tumor. Angioleiomyomas are the "pink balls in the dermis" and also part of the painful skin lesion mneumonic. This is a typical example with a very distinctive look, arising from the deep dermal and subcutaneous vessel walls. The vessels may not be a prominent component as they are often collapsed. Some variants are cellular. These are easily differentiated from piloleiomyomas, which at low power ramify through collagen bundles instead of having circumscription.
The cells have short, blunt-ended nuclei and abundant pink cytoplasm. When cut in cross-section, there are perinuclear vacuoles. The vessels are fairly inconspicuous. There is no cytologic atypia or mitotic activity.