Pulmonary angiosarcomas are usually secondary tumors, and only a few primary cases have been described. We report a unique case of epithelioid angiosarcoma arising in the lungs as a bilateral multinodular infiltrate and presenting as pulmonary hemorrhage. Because of its epithelioid histology, this tumor may resemble a carcinoma, also staining positively for keratin markers, Therefore, unless the diagnosis of epithelioid angiosarcoma is considered and endothelial markers used, the diagnosis of epithelioid angiosarcoma may be overlooked at this site. Copyright (C) 1997 by W.B. Saunders Company.