Background:Angiomatoid fibrous histiocytoma (AFH) is a clinically rare low-grade malignant soft tissue tumor with occasional metastasis,It accounts for 0.3% of all soft tissue tumors, and it occurs most frequently in the extremities, followed by the trunk and head and neck.Primary angiomatoid fibrous histiocytoma of the pulmonary bronchus is rare, In this paper, the clinical and imaging data of a case of Primary angiomatoid fibrous histiocytoma of the pulmonary bronchus are reported and the literature is reviewed. Case description:A 57-year-old female patient developed cough without obvious inducement six months ago, with paroxyspasms of dry cough, chest tightness and shortness of breath, aggravating after activity.Laboratory tests showed:C-reactive protein 50.9mg/L, ferritin 346ng/ml, AFP<0.9ng/ml, CEA 3.45ng/mL,CA199 19.U/mL,CA125 10.50U/mL,CA50 10.60IU/ml,T-SPOT(-).Chest CT scan showed bronchial occlusion, attasis and soft tissue density in the right middle lobe of the lung. Enhanced scan showed uneven enhancement of endobronchial nodules. ¹⁸F-FDG PET/CT showed a density shadow of nodular soft tissue in the right lung bronchus. The density was even and the boundary was unclear. The size was about 2.2cm×2.5cm, and the uptake of ¹⁸F-FDG was higher than that of uniform uptake, the maximum standard uptake value (SUVmax) was 11.2.Bronchoscopy showed that the mass was nodular or polypoid, nodular, yellow and tough.The results of bronchoscopic biopsy showed:there were histocytes and dendritic cells in the background of lymphocytes and plasma cells, and no components of squamous cell carcinoma.According to the imaging diagnosis, the preoperative diagnosis was inclined to lung cancer. Due to the obvious symptoms of the patient, the family members and the patient requested surgery, and the postoperative pathological diagnosis was Primary angiomatoid fibrous histiocytoma of the pulmonary bronchus. Conclusion:The incidence of primary pulmonary AFH is very low, its clinical manifestations and imaging findings lack characteristics, and the final diagnosis still needs pathology.However, when middle-aged and elderly patients were found to have soft tissue shadows in the bronchus with clear boundaries and uneven density,the enhanced scan was moderately to significantly enhanced,and high FDG uptake on PET/CT scan,AFH should be considered,and surgical resection may be the best treatment.In conclusion, this case report further broadens the spectrum of lung and bronchial tumors.