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.