Objective To analyze 18 F-FDG PET/CT imaging features and uptake types for pulmonary sarcomatoid carcinoma ( PSC) .Methods 17 cases of primary pulmonary sarcomatoid carcinoma proved by surgery and pathology were reviewed retro -spectively , all patients received 18 F-FDG PET/CT examination , their images were analyzed and compared .Results All 17 cases showed a solid single lung mass , of which 8 were in the right lung while the other 9 were in the left lung and 13 located in the up-per lobe of the lung.There were 6 cases of central type (35.3%) and 11 cases of periphery type (64.7%).Diameters ranged from 2.2 cm to 12.1 cm.The SUVmax ranged from 2.2 to 21.3.Uptake patterns of FDG were uniform nodle , irregular ring and uniform strip.6 presented with thoracia wall or pleural invasion , 12 with metastasis of lymph node of hilum and mediastinum , and 3 with metastasis .Immunohistochemically , 4 cases were pleomorphic carcinoma ( PC ) , 5 cases were spindle cell carcinoma (SCC), 8 cases were carcinosarcoma (CS).Cytokeratin was positive in 13 patients, Vimentin was positive in 17 patients, epi-thelial membrane antigen was positive in 5 patients and Desmine was positive in 2 patients.With the lesion had longer diameter , clinical stage progressed accordingly .(Υ=0.604, T <0.05).Conclusion 18F-FDG PET/CT is helpful in the diagnosis of PSC for its distinctive imaging features and uptake types , could be an acute method in clinical stages .%目的：探讨原发性肺肉瘤样癌（PSC）在18 F－FDG PET／CT显像中的影像特征和代谢特点。方法分析17例经临床和病理确诊的原发性肺肉瘤样癌（ PSC）的临床和影像学资料，并行免疫组化检查和TNM临床分期。结果17例PSC均表现为肺内单发结节或肿块。中央型6例，周围型11例，右肺8例，左肺9例，双肺上叶13例。病灶最大直径2．2～12．1cm；最大SUVmax为2．2～21．3。病灶摄取类型：4例均匀结节形，3例均匀条片形，9例不规则环形，1例混合型。6例胸膜侵犯，12例单侧（双侧）肺门和纵隔淋巴结转移，3例远处转移。病理诊断：梭形细胞癌5例，多形性癌4例，癌肉瘤8例；上皮细胞角蛋白－CK阳性13例，波形蛋白－vimentin 阳性17例，上皮细胞膜抗原－EMA阳性5例，肌间线蛋白－Desmin阳性2例。Ⅰ～Ⅳ期之间病灶直径有差异，病灶直径随临床分期的增加而增大，差异有统计学意义（Υ＝0．604， T＜0．05）。结论18 F－FDG PET／CT显像对原发性肺肉瘤样癌和临床分期有较高的诊断价值。
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