Californian Coughed Up Giant Blood Clot in Shape of His Lung

By: Yassmine ElSayed

CAIRO, Dec. 15 (SEE) – Blood is alarming whenever it appears outside the body. Coughing up blood is certainly dangerous, but not particularly rare. A man from California, however, shocked his doctors when he coughed up an unusual-looking blood clot: It was in the shape of his lung.

A recent piece at livescience.com quoted a report published at the New England Journal of Medicine, that the 36-year-old man was being treated for a serious heart condition, chronic heart failure, which means the heart muscle can't pump enough blood to meet the body's normal demands.

His condition was so severe that doctors put him on a machine which helps the heart pump blood and he was prescribed a blood-thinner medication, which also increase the risk of bleeding, including coughing up blood.

Indeed, the patient had several coughing episodes in which he expelled small amounts of blood, according to the report. But then, during an "extreme bout of coughing," the patient spit out an "intact cast" of the right bronchial tree. In other words, it was a mold (cast) made of clotted blood in the shape of the lung's branched airway passages known as bronchi.  

"We were astonished," Dr. Georg Wieselthaler, a heart and lung surgeon at the University of California, San Francisco (UCSF), who treated the patient, said. "It's a curiosity you can't imagine — I mean, this is very, very, very rare."

It's less rare for patients to cough up bronchial "casts" made of other substances, such as lymph or mucus. But blood is less sticky and sturdy than these other substances, meaning that a cast made of blood is less likely to hold together when coughed up.

Wieselthaler told that in this case, the patient had an infection that increased levels of a protein called fibrinogen, which helps blood clots form; and higher levels of fibrinogen could have helped the man's large clot to stay intact when it was coughed up.

Even though the man had no further episodes of coughing up blood, he unfortunately died a week later from complications of heart failure.

Wieselthaler's colleague, Dr. Gavitt Woodard, a clinical fellow at UCSF, said that one reason they decided to publish the image was to show the "beautiful anatomy of the human body.”