A 58-year-old Woman with Dry Cough and Pulmonary Nodules.

CXR showed bilateral diffuse nodular opacities (3 mm to 5 mm) and a small right pleural effusion (Fig. 1a). CT of thorax showed innumerable pulmonary nodules which appeared randomly distributed throughout both lungs (Figs. 1b and 1c). They were adjacent to bronchovascular bundles (yellow arrow 1b) and perivenular nodules (yellow arrow in Fig. 1c). They demonstrated an irregular outline and mostly measured at least 5 mm in diameter with no evidence of cavitation. Irregular thickening of bronchovascular bundles and small pleural effusions were noted bilaterally (Fig. 1d). No ground-glass change or consolidation was seen. Bronchoscopy, bronchoalveolar lavage and transbronchial lung biopsy (TBLB) from the left lower lobe were performed. Initial hematoxilin and eosin (H&E) sections of the TBLB showed only tiny abnormal nodules of epithelioid cells in the parenchyma. Deeper sections revealed larger tumour nodules comprising epithelioid tumour cells with small nuclei/ tiny nucleoli and a small amount of eosinophilic cytoplasm; no mitotic activity was observed. They were surrounded by strands of hyaline connective tissue as highlighted by the periodic acid-Schiff diastase (PAS-D) stain. The cells did not contain mucin vacuoles. Positive immunohistochemical stains were vimentin, CD31, CD34 Dear Editor, Pulmonary epithelioid haemangioendothelioma is a rare vascular neoplasm of endothelial origin. We describe a case which involved solely the lungs and a novel therapeutic strategy using pegylated liposomal doxorubicin was attempted.