Pleuroscopic diagnosis of disseminated hemangiosarcoma in a horse

A 7-year-old Thoroughbred mare was examined because of persistent bilateral epistaxis and respiratory distress. Evidence of bilateral pleural effusion was found during physical examination, and a large amount of serosanguineous fluid was drained from the right side of the thorax. Cytologic examination and bacteriologic culture of the transtracheal aspirate and pleural fluid did not yield evidence of sepsis. A coagulation profile was unremarkable. Radiographic and echographic changes were seen in the lung parenchyma. Pleuroscopy, with the horse standing, revealed numerous dark nodules on the pleura, diaphragm, and lung surface. On the basis of biopsy and necropsy findings, the histopathologic diagnosis was disseminated hemangiosarcoma.