An 82-year-old woman with non-alcoholic steatohepatitis and diabetes mellitus was diagnosed as having a liver tumor in S4/8 without lymph node and distant metastases, and she underwent laparoscopy-assisted hepatic resection. Histological findings showed moderately to poorly differentiated hepatocellular carcinoma and poorly differentiated cholangiocarcinoma coexisting in the tumor, and the surgical margin was negative. On the 26th postoperative day, she developed dyspnea and hypoxemia, and diffuse bilateral ground-glass opacities were seen on chest CT. This was considered to be acute respiratory distress syndrome. Though intensive treatment was started, she died of respiratory failure after 42 days. Necropsy examination of the lung showed proliferation of adenocarcinoma similar to the cholangiocarcinoma and extensive fibrillation in bilateral lungs, compatible with the diagnosis of pulmonary lymphangitis carcinomatosa. Several factors may have been responsible for the early postoperative lymphangitis carcinomatosa, including the cholangiocarcinoma component that was considered to have a higher grade of malignancy, aging, and increased surgical stress from the extensive liver resection area, which might have all accelerated tumor proliferation and metastasis.