Superior vena caval obstruction from thrombus
Neck pain with bilateral arm swelling
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This CT chest demonstrates extensive and occlusive thrombus in the superior vena cava. Superiorly it extends into the inferior aspect of right jugular vein and subclavian vein.
Associated significant mediastinal lymphadenopathy, pleural effusion and thickening of the left lung interstitial.
This is a gentleman with a known history of metastatic esophageal cancer and has been on long term therapeutic clexane for bilateral pulmonary embolism in the last few months. In this presentation, the patient's symptoms were highly suspicious for SVC obstruction. His SVC thrombosis could be due to hypercoagulable state secondary to underlying malignancy or possibly a clotting disorder.
- Cohen R, Mena D, Carbajal-Mendoza R et-al. Superior vena cava syndrome: A medical emergency?. Int. J. Angiol. 2012;17 (1): 43-6. Free text at pubmed - Pubmed citation
- Baker GL, Barnes HJ. Superior vena cava syndrome: etiology, diagnosis, and treatment. Am. J. Crit. Care. 1993;1 (1): 54-64. Pubmed citation