Abstract: Objective To look for the methods of diagnosis and differential diagnosis of pulmonary sclerosing hemangioma (PSH). Methods The clinicopathological immunohistonchemical and frozen section diagnosis features were reviewed in 20 cases of PSH. Results In 20 cases,female,right lung,double lung,left lung was 18,11,1 and 8,respectively. The average age is 55 and ranged from 32 to 68 years.Nineteen cases were isolated lung nodules,and 1 case was double lung nodules.Based on CT results,17 cases were diagnosed as lung cancer,2 as esophageal cancer and pulmonary metastasis,and 1 as pulmonary hamartoma. Based on the results from 10 intraoperative frozen section,2 cases were diagnosed as carcinoid tumor,2 bronchioloalveolar carcinoma,1 descriptive PSH,and 5 inflammatory pseudo tumor.11 cases showed a mixture of the following four histological patterns:solid,papillary,sclerotic and hemangioma-like.There were two types cells of tumor cells,cuboidal cells covered the papillary surface,and lined fissure-cavity in the solid and vascular areas,and polygonal cells with consistent size and morphology in the solid areas and papillary axis.Immunohistochemical staining revealed that the polygonal cells expressed EMA,TTF-1,Vimentin,but didn't expreesed AE1/AE3.The surface of the cubical cells expressed AE1/AE3 and TTF-1,but didn't express Vimentin. Conclusion The PSH is particularly prevalent in isolation with lung nodules in the middle-aged and old women. It was usually misdiagnosed as lung cancer by CT.It was also misdiag nosed by frozen section assay.Although tle frozen section assay could provide higher accuracy in properties judgment,most PSH were hard diagnosed exactly.Postoperative histological section with immunohistochemical inspection is an effective method among the differential diagnosis ways.