This is a video of Cassidy Hempel's Bronchoscopy that was taken at Children's Hospital of Oakland on December 10, 2009. Cassi suffers from Niemann Pick Type C disease, a genetic disease that causes the inability to process cholesterol in the cells. It appears that Cassi may have xanthomas developing - little cholesterol nodules in her lungs. Cassi's identical twin sister also has these nodules but they are not as severe.

Interestingly, xanthomas are not a feature in NPC disease so we are not sure why there are there. Possibly the girls have other cholesterol and lipid issues that we are not aware of that are causing these, including hyperlipidemia where xanthomas are more common?