At autopsy of a woman dead for two days, a dark red, rubbery, elongated mass is delivered intact from the femoral vein. Its surface is smooth, moist and glistening, and it peels away cleanly from the vessel wall without any point of attachment. The correct interpretation is:

• A Antemortem thrombus with lines of Zahn
• B Chicken fat clot indicating slow agonal stasis
• C Antemortem embolus impacted before death
• D Postmortem clot, currant jelly type ✓

Explanation

A postmortem clot is soft, rubbery, dark red and homogeneous (currant jelly) or has a pale yellow supernatant layer (chicken fat); it has a shiny, moulded surface, is not attached to the intima anywhere, and can be withdrawn whole. An antemortem thrombus is dry, granular and friable, is firmly adherent to the vessel wall, and shows laminated lines of Zahn built by flowing blood. The absence of any attachment point here excludes both an in-situ thrombus and an impacted embolus, which would show organisation or adhesion.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.