Superior vena cava obstruction

Case contributed by Dr. Ekaterina Peshevich
Diagnosis probable


Prominent superficial chest wall veins.

Patient Data

Age: 55 years
Gender: Male

A non-uniform mass lesion is seen at the anterior and middle mediastinum on the right, at the level of the lateral wall of the aortic arch, merges with the superior vena cava, reaching the wall of the right pulmonary artery, with approximate dimensions 6.3 x 4.2 cm and density of +6 to +56 HU.

On the basis of this non-contrast study, we cannot exclude invasion into vessels, as well as thrombosis of the superior vena cava. The mediastinal soft tissue structures are tightened, the contours of the brachiocephalic, and the superior vena cava are blurred, and their contents heightened density.

Bilateral mild pleural effusion, with density -15 to +20 HU.

There is a small amount of pericardial fluid content.

Other multiple lymph nodes of the mediastinum are noted reaching the size of 1.6 cm.

Case Discussion

This case demonstrates a tumor of the mediastinum with obstruction of the superior vena cava, bilateral chylothorax, and perhaps with thrombosis.

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