ObjectiveTo analyze the multi-slice spiral CT(MSCT) features of primary pulmonary invasive mucinous adenocarcinoma(IMA) so as to raise the awareness of the disease. MethodsThe MSCT characteristics of 38 cases of primary pulmonary IMA confirmed by pathological findings were retrospectively analyzed. ResultsIn the 38 patients, there were 30 (78.9%) with one lesion and 8 (21.1%) with multiple lesions. Twenty-two cases (57.9%) of isolated nodule or mass with the maximum diameter of 8.99±1.56 (range, 8-71) mm, of which 9（40.9%） reported irregular mass and 13（59.1%）reported nodule; 13 cases (59.1%) displayed a clear tumor-atelectasis interface and 9 (40.9%) unclear; 5 cases (22.7%) showed lobulated margin, 7 (31.8%) were spiculated; 7 cases (31.8%) presented vacuole sign, 6 (27.3%) reported air bronchogram sign; 7 cases (31.8%) showed pleural indentation sign; on CT enhanced scan, 7 cases (31.8%) had tumor with homogeneous density and 5 (68.2%) with nonhomogeneous density. Thirteen cases（34.2%） reported pulmonary patchy consolidation, in which 11 (84.6%) had bronchogram sign; 7 cases (53.8%) suffered from bronchial stenosis and rigidity; low density of pulmonary consolidation was observed in 3 cases (23.1%). There were 3 cases (7.9%) of multiple nodules accompanied by patchy consolidation, 10 (26.3%) of mediastinal or hilar lymph node enlargement, 15 (39.5%) of pleura and chest wall invasion, and 10 (26.3%) of pleural effusion. ConclusionPrimary pulmonary IMA is characterized by specific images, most of which present isolated nodule or mass, clear tumor-atelectasis interface, and lower density of patchy consolidation than that of chest-wall soft tissue on the same level. Understanding these CT signs is conducive to early diagnosis of the disease, but the definite diagnosis needs the combination of histopathology and immunohistochemistry.

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