Long Survival in Patients with Bronchogenic
نویسندگان
چکیده
o bstruction of the superior vena cava produces a dramatic syndrome consisting of edema and plethora of the face, neck, and arms, engorgement of the veins in the neck, and the appearance of dilated, tortuous, superficial collateral veins on the arms, neck, and upper torso.’ The patient may also suffer from dyspnea and disturbance of the sensorium, both often worse in the recumbent position, and from stridor, hoarseness, visual disturbance, convulsions, suffusion of the conjunctiva, and proptosis.’ Venous pressures in the neck and arms are always increased and are greater than the pressures in the legs or right atrium and may be paradoxically increased with inspiration.1’2’6’7 The most common cause of the superior vena cava syndrome is bronchogenic carcinoma, accounting for 75 to 90 percent of all cases.4’8 A second common cause is lymphoma.4 Other neoplastic diseases cause most of the remaining cases,4 although the list of possible causes is long. Uncommon causes of the superior vena cava syndrome include metastatic cancer,4 aortic aneurysm (atherosclerotic or syphilitic ) ‘#{176} retrosternal goiter,7” mediastinitis (idiopathic, tuberculotic, histoplasmotic, actinomycotic, syphilitic, or pyogenic ) and iatrogenic causes (central venous catheter, wire of pacemaker, irradiation-induced pneumonitis, yen-
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