It might look like coral, or even the White House's Christmas decorations, but according to Doctors this ghastly red tendril submitted to the The New England Journal of Medicine is a six-inch-wide blood clot that was coughed up by a patient perfectly intact.
Doctors Gavitt A. Woodard and Georg M. Wieselthaler from the University of California at San Francisco aren't exactly sure how the clot formed or how it was coughed up intact, but the clot created such a perfect cast they knew immediately it had come from their patient's right bronchial tree.
Dr. Wieselthaler hooked the patient up to a pumped designed to assist blood circulation, but since the pump can cause blood clots to form patients also have to take blood-thinning medication.
"You have high turbulence inside the pumps, and that can cause clots to form inside," says Dr. Wieselthaler. "So with all these patients, you have to give them anticoagulants to make the blood thinner and prevent clots from forming."
Without the ability to form clots though there is an increased risk of internal bleeding. In this case blood exited the patient's pulmonary network and went into the bronchial tree. Soon the patient started coughing up blood clots.
"During the next week, the patient had episodes of small-volume hemoptysis, increasing respiratory distress, and increasing use of supplemental oxygen (up to 20 liters delivered through a high-flow nasal cannula). During an extreme bout of coughing, the patient spontaneously expectorated an intact cast of the right bronchial tree."As to how the clot remained intact Wieselthaler thinks it could have been a build up of a protein found in blood plasma known as fibrinogen which helps forms clots.
Unfortunately the patient died a week after coughing up the clot, but Wieselthaler and his team won't be forgetting the case anytime soon. Although such clots are not unprecedented at this size they are almost unheard of.
"We were astonished. It's a curiosity you can't imagine—I mean, this is very, very, very rare."
As the image of the clot made the rounds on social media many were fascinated by the medical marvel.
While others wanted nothing to do with it.
And some tried banning the cursed image back to the darkness from whence it came.
One thing's for sure though, flu and cold season just got a whole lot scarier.
H/T - Twitter, The Atlantic, Gizmodo