Diagnostic Procedures in Patients With Superior Vena Cava Syndrome

Understandably, the swollen plethoric face, the conjunctival edema of chemosis, and the distended neck veins and collaterals that indicate superior vena cava syndrome (SVCS) provoke visions of impending catastrophe. Usually, the radiotherapist or oncologist is summoned to administer emergency treatment, frequently in patients without a proved diagnosis of neoplastic disease. Thereafter, diagnostic procedures may be complicated by radiation reaction, and tissue alterations owing to cytotoxic therapy may impair histological interpretation. If the same patient had presented with a mediastinal mass, but no SVCS, his physician would have embarked on a careful plan of investigation. Perhaps he would employ one or more radiological and radionuclide procedures, but eventually a biopsy would be performed to establish specific histological diagnosis.At least 50% of all patients with SVCS have primary carcinoma of the lung (increasingly, small cell carcinoma). Approximately 15% have lymphoma, 15% have other malignant neoplasms, and 15% have benign disease such