The doctors used a fine needle to draw out what was in the masses to try to understand what was going on. But all they got out was dead tissue debris and immune cells, which wasn’t very helpful. Given the masses, blood clots, and spreading necrotic ulcer, the man was sent to surgery. The doctors surgically removed the ulcer and masses and closed off the clotted veins. They then had to use tissue from the man’s thigh to reconstruct his neck.
Jinxed ink
The final diagnosis was necrotizing granulomatous lymphadenitis, which means that clumps of immune cells formed amid inflammation, his lymph nodes became inflamed and swollen, and there was also dead tissue. It’s unclear exactly how it all happened, but the doctors had several hypotheses.
A central theory is that he had an abnormal immune response to the tattoo—red organic dyes and heavy metals that can be found in some tattoo ink have been linked to this before. In one possible scenario, the abnormal immune response led to immune cell clumping, causing his lymph nodes to swell and press against his vasculature. This in turn slowed blood flow in his neck, causing cells to die.
Another possibility is that chronic inflammation from the tattoo caused the walls of his veins to start eroding, also leading to cell death. A biopsy showed necrosis in his jugular veins that supports this hypothesis. It’s also possible that the inflammation response involved a variety of aberrant immune responses that spurred a hyper-coagulant state, meaning his blood formed clots more easily. Blood clots in his neck could have also led to a necrotic lesion.
While doctors can’t say for sure what happened—or if it involved some sort of divine retribution—they say the case expands the possibilities of bad outcomes from tattoos and clinicians should be aware of it.
Meanwhile, the man recovered from the ordeal after comprehensive support. He was likely advised to avoid tattoos—and possibly holy water.
