陜西西安70歲的張大爺平時愛吃辣，前段時間體檢發(fā)現(xiàn)右肺下葉有2.1厘米結(jié)節(jié)，CT顯示有毛刺、有分葉、貼著胸膜，多家醫(yī)院一致判斷為“周圍型肺癌”。

誰知手術(shù)切除后，醫(yī)生一刀下去——剖開的竟是一截0.5厘米長的紅色辣椒尖！

A 70-year-old man surnamed Zhang in Xi'an, Northwest China's Shaanxi province, went into surgery for what several hospitals believed to be a likely case of peripheral lung cancer. To everyone's relief, the suspected tumor was actually a 0.5-centimeter red chili tip, already sliced in half by the scalpel.

The story started when Zhang had a health check recently that detected a 2.1-centimeter nodule in the lower lobe of his right lung. CT scans showed spiculation, lobulation, and pleural attachment, all features that made doctors at multiple hospitals suspect peripheral lung cancer.

But the operation produced a surprise twist. Instead of a tumor, the culprit was a tiny piece of chili that had apparently been hiding deep in Zhang's lung.

醫(yī)生表示，從業(yè)近30年僅遇過3例，辣椒在CT下與肺組織密度幾乎一致，極易被誤診為肺癌。

視頻來源：@陜視新聞

據(jù)了解，大爺無辣不歡，想來是吃飯時不慎嗆入，辣椒尖卡在肺里久了，周圍組織發(fā)炎增生，偽裝成腫瘤模樣。

Li Wenhai, deputy director of the Thoracic Hospital of Xi'an International Medical Center Hospital and the chief surgeon for Zhang's operation, said that in nearly 30 years of medical practice, he had encountered only three such cases.

"Chili has almost the same density as lung tissue on CT scans," Li said. "Every patient was admitted as a suspected lung cancer case, and no one expected before surgery that it would turn out to be chili."

According to the report, Zhang is known to enjoy spicy food. Doctors believe he may have accidentally inhaled the chili tip while eating, and the foreign body stayed in his lung long enough to trigger inflammation that made it look like a tumor.

原本懷疑是腫瘤手術(shù)，卻發(fā)現(xiàn)只是個辣椒，辣椒為什么偽裝得這么深？

西安國際醫(yī)學(xué)中心醫(yī)院胸科醫(yī)院副院長李文海是主刀醫(yī)生，他解釋，辣椒尖是一種錐形結(jié)構(gòu)，前尖后寬?！扒懊婕?，后面像個喇叭，咳不出來?！?strong>一旦被吸入氣道，它會順著氣流一路往下走，直到卡在某個直徑相當(dāng)?shù)募氈夤芾铩?/strong>

這個特殊的形態(tài)，讓辣椒成了氣道異物里的常客。米粒、花生碎被嗆進去，劇烈的咳嗽反射往往能將其排出；但辣椒尖只會越卡越深，它在肺里待久了，局部組織會反復(fù)發(fā)炎、增生，逐漸形成一個炎性肉芽腫包裹的結(jié)節(jié)。從CT上看，它有毛刺、有分葉、密度不均——所有肺癌的影像特征，它幾乎都具備。

Li explained that a chili tip has a cone-like shape, sharp at the front and wider at the back. Once inhaled into the airway, it may not be coughed out. Instead, it can travel downward with the airflow until it becomes stuck in a small bronchus of roughly the same diameter and stays there.

That special shape makes chili tips frequent "troublemakers" among inhaled foreign bodies. Rice grains or crushed peanuts may trigger strong coughing and be expelled, but a chili tip can wedge itself deeper and deeper. After remaining in the lung for a long time, it can cause repeated local inflammation and tissue proliferation, eventually forming a nodule surrounded by inflammatory granulomas, media reported.

On CT scans, such a nodule may show spiculation, lobulation, and uneven density, which are all typical signs of an image suggesting lung cancer.

“辣椒本身在CT下和肺組織密度幾乎一致，我從業(yè)近30年，這是碰到的第3例”，李文海說：“每一例都是以肺癌入院，術(shù)前誰都沒想到是辣椒?！?/p>

李文海副院長提醒，氣道異物吸入并不罕見，尤其是老年人和兒童。老年人吞咽反射減弱，吃飯時說話、大笑、分心，都容易把食物嗆進氣管。

“如果能早一點做氣管鏡，把辣椒夾出來，老張就不用挨這一刀了。”

"If a bronchoscopy had been done earlier and the chili had been removed, Zhang would not have needed this surgery," Li said.

Li reminded the public that airway foreign body aspiration is not rare, especially among the elderly and children. Older people may have weaker swallowing reflexes, and talking, laughing or being distracted while eating can increase the risk of food entering the airway.

李文海副院長給出實用建議：

第一，吃飯時細嚼慢咽，口中有食物時，別說話、別激動。“很多氣道異物都是在飯桌上聊出來的。”吃飯時大笑、大聲說話、打鬧，都容易讓食物走錯路。尤其是有老人和小孩的家庭，吃飯時要營造安靜的氛圍，避免一邊吃一邊說笑。

第二，一旦發(fā)生嗆咳，別硬扛。喝水嗆到：頭低位，輕拍背部，一般能緩解。嗆入飯?；蛐K食物：如果咳嗽劇烈但咳不出來，立即采用海姆立克急救法，爭取把異物沖出來。

He advised people to chew slowly and avoid talking or becoming too excited while there is food in the mouth. If rice grains or small pieces of food are inhaled and forceful coughing fails to expel them, the Heimlich maneuver should be performed immediately to help force out the foreign body.

嗆咳后癥狀持續(xù)或反復(fù)出現(xiàn)咳嗽、發(fā)熱、痰中帶血：及時到醫(yī)院做檢查，必要時做氣管鏡探查。

來源：人民日報 環(huán)球時報 央視網(wǎng) @陜視新聞 西安國際醫(yī)學(xué)中心醫(yī)院 錢江晚報等

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