DThe attached medical terminology makes the situation almost tolerable: "In an extreme coughing attack, the patient spontaneously spat out an intact imprint of the right bronchial tree."

Translate into layman terms, and suddenly life is a bloody horror movie: a poor patient hacked up a bloody perfect replica of the right lung side.

In one now viral tweet, The New England Journal of Medicine published a photo on 6 December with the 6-inch-wide blood clot. The creator of the cast, a 36-year-old man hospitalized for heart failure, died of medical complications a week later.

right bronchial tree.
Some say that the cast of the right bronchial tree looks like a red decorative coral or a holiday tree decorated with red lights. Your choice.

The NEJM She regularly drops medical pictures that are not safe for the squeamish, but this clot took the Internet's breath away. In addition to many shocked GIF images, the photo collected 2,244 retweets and over 4,200 likes at the time of publication of this article.

This gross event has taken place before

Unfortunately – here's your rough content warning – this is not nearly the first time patients have coughed up their lungs. Twitter user @ chifle12 registered similar crude artifact from a 6-year-old out of lymphatic fluid. Patients who suffer from asthma can also form mucus that hardens in the airways.

And there is more. A 34-year-old woman suffering from a laryngeal diphry produced a similar occupation of her trachea in 1926. Recently, a 25-year-old pregnant woman hacked another bronchial blood clot in 2005. In this case, the patient recovered and gave birth to a healthy baby.

The special thing about this latest instance is the material and the unparalleled size. Not only is blood less harsh than other body materials that can reach this rough shape, but the patient's 6 inch wide specimen was also completely intact. Georg Wieselthaler, MD, a graft and pulmonary surgeon at the University of Florida, San Francisco, immediately identified the source of the massive lump.

"We were surprised," Wieselthaler said The Atlantic, Based on the way the clot faithfully tracked the patient's airway, he and his team quickly identified it as his right bronchial tree. "It's a curiosity you can not imagine – I mean, that's very, very, very rare."

How did this rough blood form?

Doctors have some ideas to explain this massive medical anomaly.

When the human body is running right, Bronchies are the pathways to the oxygen you breathe and the carbon dioxide you excrete. Like an upturned tree, the web of branches becomes smaller bronchioles that are closed at the tips of alveoli, and where your blood carries red blood cells, it absorbs oxygen and carbon dioxide.

The unhappy patient had much more than just air in his bronchi. When he was admitted to the intensive care unit, the doctors squatted him on a ventricular device called Impella, which maintains blood flow. However, the turbulence of the smallest cardiac pumps in the world can lead to clots. The doctors counteracted the effect by giving the man an anticoagulant to dilute his blood.

The anticoagulant has a price – with thinner blood, the body may have difficulty eliminating fractures or cracks that open inside. In this case, the patient's blood reached his right bronchial tree and coughed small lumps for days.

To make the record-breaking clot, doctors suspect that infection has caused the patient to produce a higher concentration of fibrinogen, a protein found in blood plasma that acts as an "adhesive." Gavitt Woodard, MD, a clinical fellow at UCSF, believes that this protein provided a newly discovered hardness that kept the clot intact.

"Because it was so big, he could generate enough power from the entire right side of his chest to push it up," Woodard said The Atlantic,

Although the patient ultimately did not recover, the doctors report that he found relief.

In the meantime, the incident leaves the Internet and reflects on how the term "lung cough" can be uncomfortably close to real life.