陕西西安70岁的张大爷平时爱吃辣，前段时间体检发现右肺下叶有2.1厘米结节，CT显示有毛刺、有分叶、贴着胸膜，多家医院一致判断为“周围型肺癌”。
谁知手术切除后，医生一刀下去——剖开的竟是一截0.5厘米长的红色辣椒尖！
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.
医生表示，从业近30年仅遇过3例，辣椒在CT下与肺组织密度几乎一致，极易被误诊为肺癌。
视频来源：@陕视新闻
据了解，大爷无辣不欢，想来是吃饭时不慎呛入，辣椒尖卡在肺里久了，周围组织发炎增生，伪装成肿瘤模样。
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.
原本怀疑是肿瘤手术，却发现只是个辣椒，辣椒为什么伪装得这么深？
西安国际医学中心医院胸科医院副院长李文海是主刀医生，他解释，辣椒尖是一种锥形结构，前尖后宽。“前面尖，后面像个喇叭，咳不出来。”一旦被吸入气道，它会顺着气流一路往下走，直到卡在某个直径相当的细支气管里。
这个特殊的形态，让辣椒成了气道异物里的常客。米粒、花生碎被呛进去，剧烈的咳嗽反射往往能将其排出；但辣椒尖只会越卡越深，它在肺里待久了，局部组织会反复发炎、增生，逐渐形成一个炎性肉芽肿包裹的结节。从CT上看，它有毛刺、有分叶、密度不均——所有肺癌的影像特征，它几乎都具备。
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下和肺组织密度几乎一致，我从业近30年，这是碰到的第3例”，李文海说：“每一例都是以肺癌入院，术前谁都没想到是辣椒。”
李文海副院长提醒，气道异物吸入并不罕见，尤其是老年人和儿童。老年人吞咽反射减弱，吃饭时说话、大笑、分心，都容易把食物呛进气管。
“如果能早一点做气管镜，把辣椒夹出来，老张就不用挨这一刀了。”
"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.
李文海副院长给出实用建议：
第一，吃饭时细嚼慢咽，口中有食物时，别说话、别激动。“很多气道异物都是在饭桌上聊出来的。”吃饭时大笑、大声说话、打闹，都容易让食物走错路。尤其是有老人和小孩的家庭，吃饭时要营造安静的氛围，避免一边吃一边说笑。
第二，一旦发生呛咳，别硬扛。喝水呛到：头低位，轻拍背部，一般能缓解。呛入饭粒或小块食物：如果咳嗽剧烈但咳不出来，立即采用海姆立克急救法，争取把异物冲出来。
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.
呛咳后症状持续或反复出现咳嗽、发热、痰中带血：及时到医院做检查，必要时做气管镜探查。
来源：人民日报 环球时报 央视网 @陕视新闻 西安国际医学中心医院 钱江晚报等
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