Objective        To investigate the clinicopathological characteristics of pulmonary sclerosing hemangioma (PSH)

and explore the methods for diagnosis and differential diagnosis of PSH.       Methods        Clinical manifestations and histological and immunohistochemical features of 59 patients with PSH were retrospectively analyzed.       Results        There were 54 female patients including 24 patients with PSH on the left lung

33 patients with PSH on the right lung

and 2 patients with PSH on bilateral lungs. They were aged from 15-79  with an average of 49. Clinical manifestation showed cough with blood-tinged sputum in 13 patients

chest pain in 3 patients

fever in 1 patient

and no obvious symptoms in 42 patients. Imaging examination showed 56 patients with single nodule and 3 patients with multiple nodules

and the diameter the nodules ranged from 0.8 cm to 10 cm. Twenty patients were diagnosed as lung cancer

15 patients as PSH

4 patients as inflammatory pseudotumor

3 patients as pulmonary tuberculosis

2 patients as hamartoma

2 patients as pulmonary metastatic carcinoma

1 patient as infection

and 12 patients as other diagnoses. The tumor tissues were composed by epitheloid cells and oval cells

and four histological patterns were observed including solid area

papillary area

sclerotic area

and hemangioma-like area. Immunohistochemical staining revealed that the epithelioid cells expressed TTF-1

CK and EMA

while the oval cells expressed TTF-1

vimentin and EMA as well as partial expression of CD56 and Syn.       Conclusion        PSH is a rare tumor that is particularly prevalent in isolated lung nodules in middle-aged women and may originate from primitive respiratory multipotent stem cells. It is usually misdiagnosed as lung cancer. Histological section combined with immunohistochemical inspection is effective for differential diagnosis of PSH.