man coughs up perfect cast of bronchial tree

In the disgusting-but-amazing department (beware, vivid color photo at link):

Cast of the Right Bronchial Tree



Holy shit. Guy died anyway. How can you get that up?

looks at link
nods in agreement

That is amazing. That poor patient - I can’t even imagine how a person would actually be able to cough that out.

It’s sad he died of course, but holy shit that’s amazing.

The guy was so young to be having such health problems, I wonder if it was just bad genes or what, either way, poor guy.

Sort of the thoracic version of childbirth.

I wonder if he was from a lesser-developed country and had rheumatic fever, or some kind of birth defect that wasn’t corrected until he was much older than it’s normally done in this country. It’s very unusual for someone who’s 36 to have a valve replacement, in addition to all the other problems he had.

I collect old medical books, and apparently coughing up bronchial casts was not uncommon back in the day when tuberculosis was untreatable.

A question for Qadgop, Dseid, etc.: what would this cast have been made of? Mucus? Mucous membrane? Calcium deposits? I’m curious.

I don’t think that was a cast of his R bronchial tree, I think he coughed up his R bronchial tree.

I’ve actually heard of this. It’s called plastic bronchitis. It’s a known complication of congenital heart disease, among other things. Like kids who have Fontan circulation secondary to being born with only one working ventricle.

Edit: It’s called “bronchitis” but it’s a problem with the lymph system, not an actual infection.

It’s a blood clot. There’s some explanation here:

Baader-Meinhof phenomenon at its finest! The SO of a coworker coughs these up regularly due to an abnormal communication between the lungs and the lymph system. I saw a pic just a few days ago

Simple explanation of plastic bronchitis here (no gory pictures) :

I’m confused. Is that actually part of the bronchial tree or an actual cast of it from clotted blood? As in the blood filled it, clotted and then he hacked out the formed blood clot? Because it looks like he coughed out part of his actual lung.

That’s nasty. I’m sure if those were more common, however, there’d be a bronchial cast eating challenge on YouTube.

The Atlantic article posted by Riemann has a great description and explanation:

*The clot is beautiful, and it’s also kind of gross. The tweet received a slew of replies from those frightened that the photo showed an actual coughed-up lung, which is about as likely to happen as your brain falling out of your butt.[emphasis added] But even the doctors who treated the 36-year-old man who produced the clot aren’t entirely sure how it could have emerged without breaking. . . .

Congealed blood is less sturdy and sticky than hardened lymph or mucus, so why didn’t the cast break apart?

. . . the answer might involve fibrinogen, a protein component of blood plasma that essentially acts as the “glue” of a clot by trapping platelets to form a mass. The infection that Wieselthaler’s patient had, in addition to aggravating his heart failure, caused a higher-than-normal concentration of fibrinogen in his blood. It’s possible, Wieselthaler says, that the blood in his airways was unusually rubbery, capable of surviving the bumpy ride up the trachea unscathed.*

That thing is a museum piece. Maybe they could auction it off to help pay for the funeral.

How much of medicine is “Let me help you” vs “Ew, that’s so gross/cool, I need to write a paper about it?”

He goes through that on a “regular basis”?! :eek:

I think I’d rather eat a bullet and be done with it. :frowning: