The Daily PANCE and PANRE Extended Edition: Question 50

A 59-year-old, heavy smoker, presents for the evaluation of facial swelling. Upon examination, you note swelling, not only of the face but also of the neck and upper extremities. You appreciate diminished breath sounds and tactile fremitus in the right upper lobe. Which of the following diagnosis is most likely?

  1. Pancoast tumor
  2. Tuberculosis
  3. pneumothorax
  4. superior vena cava syndrome
  5. pneumonia

Answer: D

Superior vena cava syndrome

This is superior vena cava syndrome suggestive of bronchogenic carcinoma causing lymphadenopathy in the mediastinum which can impinge on the SVC.

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