Applications of the orbital angular momentum (OAM) of light range from the next generation of optical communication systems to optical imaging and optical manipulation of particles. Here we propose a micron-sized semiconductor source that emits light with predefined OAM pairs. This source is based on a polaritonic quantum fluid. We show how in this system modulational instabilities can be controlled and harnessed for the spontaneous formation of OAM pairs not present in the pump laser source. Once created, the OAM states exhibit exotic flow patterns in the quantum fluid, characterized by generation-annihilation pairs. These can only occur in open systems, not in equilibrium condensates, in contrast to well-established vortex-antivortex pairs. DOI: 10.1103/PhysRevLett.119.113903 The physics of orbital angular momentum (OAM) of light has attracted considerable attention ([1-3] and references therein). The interest in the physics of OAM extends beyond the characterization and preparation of light beams with nonzero OAM, and includes such topics as rotational frequency shifts [4,5], detailed analysis of the vortex physics [6], the physics of OAM in second-harmonic generation [7,8], optical solitons with nonzero OAM [9], transfer and conservation of OAM from pump to downconverted beams [10,11], OAM conservation in degenerate four-wave mixing [12], data transmission using OAM multiplexing [13], and quantum optical aspects such as entanglement [14]. In addition, manipulation and creation of OAM states using coherence gratings [15], liquid crystals [16], and metasurfaces [17] has been reported.There is also a vast body of research on exciton polaritons in semiconductor microcavities. Here, being part of the polaritons, otherwise noninteracting photons experience effective interactions through the polaritons' excitonic component. This combines the advantages of nonlinear systems with the ease of measuring optical beams. Polaritons form a quantum fluid, and prominent examples of observed phenomena include parametric amplification [18] and Bose condensation ([19,20] and references therein). Polaritonic quantum fluids can support vortices [21,22], and it was recently demonstrated that OAM can be transferred to polaritonic Bose-Einstein condensates using chiral polaritonic lenses [23], and that the number of vortices can be controlled by controlling the OAM of the pump beams [24,25].The question remains whether the relatively strong interaction between polaritons can be used to manipulate, in a well-controlled fashion, the orbital and/or spin angular momentum of polaritons (and thus the light field emitted from the cavity). For example, is it possible to use a beam with OAM of m p and create additional OAM contributions, say two components of OAM m 1 and m 2 , and to use the light beam characteristics of frequency and intensity to control m 1 and m 2 ? The fact that rotationally symmetric states can be unstable under sufficiently large interactions is well known, and examples include spatial pattern formation in chemica...