Peliosis hepatis is an uncommon vascular lesion of unknown etiology, and its occurrence has been linked frequently to therapy with androgenic-anabolic steroids. Extrahepatic peliosis is ever rarer. It is found most commonly in the spleen and usually in conjunction with peliosis hepatis. Documented here is an unusual case of pulmonary peliosis, associated with peliosis hepatis and peliosis of the spleen, in a 40-year-old man who had Fanconi's anemia and who received long-term therapy with fluoxymesterone and methyltestosterone. To our knowledge, this represents only the second reported case of pulmonary peliosis in the English literature.