Malignant mesothelioma masquerading as a multinodular bronchioloalveolar cell adenocarcinoma with widespread pulmonary nodules.

A 72-year-old man had a unilateral pleural effusion and multiple bilateral pulmonary nodules. Thoracoscopic biopsy revealed multiple discrete nodules in the pleura and lung. The latter consisted of tall columnar malignant cells arranged on alveolar surfaces in a lepidic growth pattern.