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SVC Syndrome

SVC Syndrome. Sung Chul Hwang, M.D. Dept. of Pulmonary and Critical Care Medicine Ajou University School of Medicine. Introduction.

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SVC Syndrome

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  1. SVC Syndrome Sung Chul Hwang, M.D. Dept. of Pulmonary and Critical Care Medicine Ajou University School of Medicine

  2. 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

  3. Etiology • Malignancy 66/86 (YUMC) • Mediastinal fibrosis 2 • Thrombosis 1 • Inflammatory 0 • Radiation fibrosis 0 • Unknown 31

  4. Symptoms and Signs • Suffusion • Dyspnea • Cough • Pain • Neck Vein Distention • Venous engorgement • Edema • Cyanosis

  5. Diagnosis • History • Physical Examination • X-rays and CT Scans • Tissue Diagnosis

  6. Diagnostic Methods • Bronchoscopy • Lymph node biopsy • Sputum cytology • Pleural biopsy • Thoracotomy • Bone marrow biopsy

  7. Treatment of SVC Syndrome • Radiotherapy • Chemotherapy : Small cell Ca, Lymphoma • Diuretics • Corticosteroid • Endovascular Stents

  8. Prognosis • Poor • Inoperable • Not treated : 3- 4 weeks • If treated : about 10 months

  9. SVC Invasion by Lung Cancer

  10. SVC Invasion by Lung Cancer

  11. SVC Syndrome and the stents

  12. Lymphoma with SVC SD F/26 DOE for 2 months

  13. Lymphoma with SVC SD

  14. Lymphoma with SVC SD

  15. 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 changes • Partially calcified Mass on CT is diagnostic

  16. Fibrosing Mediastinitis F/29 with SVC Syndrome by Histoplasmosis

  17. Fibrosing Mediastinitis F/29 with SVC Syndrome by Old Histoplasmosis

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