Lai Yutian, Huang Jian, Zhou Xudong, Du Heng, Che Guowei
Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, China.
J Thorac Dis. 2017 Mar;9(3):E180-E182. doi: 10.21037/jtd.2017.03.35.
Bronchial foreign body is a common health problem worldwide, types of bronchial foreign bodies are variegated, depending on patient age and cultural background including religious beliefs as well as alimentary habits. However, misdiagnoses caused by regional dietary correlation factors were rarely concerned. In this case, a 52-year-old woman with aggravated cough and hemosputum took thoracic CT scan twice and flexible fiberoptic bronchoscopy 5 times, which all revealed the chronic pulmonary inflammation. Furthermore, the biopsies showed bronchial granulation nodule formation. With the highly suspicion of tumor, lung lobe resection was conducted. However, from the resected specimen, we belatedly found a red pepper inserted in the bronchus, without tumor cell in postoperative pathological analysis. We reviewed the case, analyzed the potential factors that may led to repeated misdiagnoses, and concluded that regional dietary characteristics and higher clinical suspicion should be seriously under consideration in the process of diagnosis.
支气管异物是全球常见的健康问题，支气管异物的类型多种多样，这取决于患者的年龄、文化背景（包括宗教信仰）以及饮食习惯。然而，由地域饮食相关因素导致的误诊却很少受到关注。在本病例中，一名52岁的女性因咳嗽加重和咯血进行了两次胸部CT扫描及5次纤维支气管镜检查，所有检查均显示为慢性肺部炎症。此外，活检显示有支气管肉芽结节形成。由于高度怀疑肿瘤，遂进行了肺叶切除术。然而，从切除的标本中，我们事后发现支气管内插入了一颗红辣椒，术后病理分析未发现肿瘤细胞。我们回顾了该病例，分析了可能导致反复误诊的潜在因素，并得出结论，在诊断过程中应认真考虑地域饮食特点和提高临床怀疑度。
