目的 分析肺炎型黏液腺癌的影像表现及对应病理基础，探讨其形成及播散的机制。方法 回顾首都医科大学附属 北京世纪坛医院2015年11月至2019年12月收治的肺癌患者。影像初筛表现为磨玻璃渗出、片状不规则实变等影像学符合肺 炎，通过病理最终确诊为肺黏液腺癌的 19例患者，并整理出对应的临床资料及病理资料。结果 17例患者出现咳嗽、咳痰症 状，1例无明显症状，1例表现为咳嗽。影像学表现为片状分布实变（100%）、磨玻璃渗出（78.9%）、空洞（15.8%）、支气管充气征 （26.3%），52.6%双侧肺部受累，15.8%左肺下叶受累，15.8%右肺下叶受累。73.7%的患者经过评估后给予药物化疗，3例行肺 叶切除，1例靶向治疗。中位生存时间6个月。肺炎型黏液腺癌可累及多叶多段肺叶，抗感染治疗效果不佳，磨玻璃渗出、实变 从病理上判断为肺泡腔内黏液填充及部分肿瘤细胞的播散。同时对患者排出的黏液痰涂片行迪夫染色，可见肿瘤细胞。结 论 影像表现为磨玻璃影、实变，同时有结节、空洞、枯树枝征等表现，需要考虑肺炎型黏液癌的可能。影像上磨玻璃改变警惕 肺黏液腺癌通过黏液中腺癌细胞播散进而导致的支气管‐肺内转移。

Objective To elucidate the mechanism of the formation and dissemination of pneumonia type mucinous adenocarcinoma, to improve the diagnostic level of pneumonia type mucinous adenocarcinoma, and to explore the prognosis of the disease. Methods 19 patients with pulmonary mucinous adenocarcinoma were diagnosed by pathology, and the corresponding clinical and pathological data were sorted out. Results 17 patients had cough and expectoration symptoms, 1 patient had no obvious symptoms, 1 patient had cough. The imaging findings included patchy consolidation (100%), ground glass exudation (78.9%), cavity (15.8%), bronchial inflation sign (26.3%), bilateral lung involvement (52.6%), left lower lobe involvement (15.8%) and right lower lobe involvement (15.8%). 73.7% of the patients received chemotherapy after evaluation, 3 cases underwent lobectomy and 1 case targeted therapy. The median overall survival (median OS) was 6 months. Pneumonic mucinous adenocarcinoma may involve multiple lobes and segments of the lung. The effect of anti⁃infective treatment is not good. Ground glass exudation and consolidation are pathologically determined as mucus filling in the alveolar cavity and dissemination of some tumor cells. At the same time, Duff staining of sputum smear showed tumor cells. Conclusion When the imaging findings are ground glass opacity, consolidation, nodules, cavities and dead branches, the possibility of pneumonic lung cancer should be considered. The change of ground glass on imaging needs to be alert to the bronchial lung metastasis caused by the dissemination of adenocarcinoma cells in mucus.