SVC Syndrome Sung Chul Hwang, M.D. Dept. of Pulmonary and Critical Care Medicine Ajou University...
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Transcript of SVC Syndrome Sung Chul Hwang, M.D. Dept. of Pulmonary and Critical Care Medicine Ajou University...
SVC Syndrome
Sung Chul Hwang, M.D.Dept. of Pulmonary and Critical Care Medicine
Ajou University School of Medicine
Introduction
• A medical entity where compression of SVC by various causes brings clinical symptoms and signs of facial, upper body edema, formation of collateral circulations, and causes cyanosis and dyspnea
• 1757 William Hunter• Malignancy– most common• Fibrosing mediastinitis
Etiology
1) Malignancy 66/86 (YUMC)2) Mediastinal fibrosis 23) Thrombosis 14) Inflammatory 05) Radiation fibrosis 06) Unknown 31
Symptoms and Signs
1) Suffusion2) Dyspnea3) Cough4) Pain5) Neck Vein Distention6) Venous engorgement7) Edema8) Cyanosis
Diagnosis
• History• Physical Examination• X-rays and CT Scans• Tissue Diagnosis
Diagnostic Methods
• Bronchoscopy• Lymph node biopsy• Sputum cytology• Pleural biopsy• Thoracotomy• Bone marrow biopsy
Treatment of SVC Syndrome
• Radiotherapy• Chemotherapy : Small cell Ca, Lymphom
a• Diuretics• Corticosteroid• Endovascular Stents
Prognosis
•Poor• Inoperable•Not treated : 3- 4 weeks• If treated : about 10
months
SVC Invasion by Lung Cancer
SVC Invasion by Lung Cancer
SVC Syndrome and the stents
Lymphoma with SVC SD
F/26 DOE for 2 months
Lymphoma with SVC SD
Lymphoma with SVC SD
Fibrosing Mediastinitis
• 20- 40 years• Cough, Dyspnea, or Hemoptysis• Most common cause of Benign SVC syndrome• Almost always remote Histoplasmosis• Plain X-rays may be normal or only minimal ch
anges• Partially calcified Mass on CT is diagnostic
Fibrosing Mediastinitis
F/29 with SVC Syndrome by Histoplasmosis
Fibrosing Mediastinitis
F/29 with SVC Syndrome by Old Histoplasmosis