Objective To investigate CT,clinical and pathological features of primary pulmonary lymphoepithelioma-like carcinoma (LELC). Methods The clinical,CT and pathological data of 22 patients with pulmonary LELC confirmed by pathology were analyzed retrospectively, including 8 males and 1 4 females whose ages were from 1 8 to 88 years old.Results Among 22 cases,1 2 patients were found by physical examination,2 patients had cough and sputum,7 patients had cough hemoptysis and 1 patient was found by re-examination after breast cancer surgery.On CT,all cases manifested single mass in the lung,and the longer diameters ranged from 1.5 cm to 1 1 cm,in which there were central type tumors in 8 cases and peripheral type tumors in 14 cases.Nineteen masses showed homogeneous density in non-enhanced scan,and the cavity,irregular calcification and small patchy necrosis were seen in each 1 case.After contrast-media injected,masses were mild-moderately or evidently enhanced in 7 cases and 1 5 cases respectively.Eighteen cases had well defined border and unclear border in 4 cases.Vascular encasement were found in 6 central type tumors,8 tumors squeezed peripheral vascular and 8 cases had clear demarcation between tumors and vascular.Nineteen tumors were surgically removed,in which 7 cases appeared metastasis of lymph node.Histopathology showed that the tumor cells had large volumes,unclear boundaries,large nuclei,growing in syncytial nest-like patches.There were abundant lymphocyte and plasma cell infiltration in tumor’s mesenchyma.EBER were done in 1 6 cases and the results were all positive.Conclusion CT feature of pulmonary LELC manifestes that the masses are mostly single,large size, homogeneous density,clearly boundary,shallow lobulated and significantly enhancement.Vascular encasement is the feature of central pulmonary LELC,and peripheral LELC is more likely to occur in the sub-pleural region.Final diagnosis should be combined with clinical and pathological diagnosis.