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It's possible to identify an obstructed superior vena cava with chronic thrombosis. There is an exuberant collateral venous circulation on thorax characterized by: Dilated azygos vein, dilated pericardial veins, dilated anterior thoracic vein and other smaller mediastinal veins that drain to left renal vein and inferior vena cava.
There is also left pleural effusion.
No signs of pulmonary embolism.