At autopsy, a large firm mass is found in the right atrium. On cutting, it has a smooth glistening surface, a rubbery consistency, and a dark red outer zone with a yellow central portion. It separates easily from the endocardium. The most likely diagnosis is:

• A Antemortem thrombus
• B Antemortem ball thrombus
• C Postmortem clot of the chicken fat type
• D Postmortem clot of the currant jelly type ✓

Explanation

A postmortem clot is soft, rubbery, shiny, moulded to the chamber, and non-adherent to the wall. The currant jelly variety is uniformly dark red and forms when red cells settle evenly throughout the clot. The chicken fat variety is yellow because red cells have sedimented leaving a supernatant fibrin layer, and mixed clots show yellow centre with red periphery. An antemortem thrombus is dry, friable, laminated with lines of Zahn, and firmly attached to the vessel or endocardial surface.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

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Written and medically reviewed by the StethoPrep medical team.