Superior vena cava syndrome caused by mediastinal lymphoma: A rare clinical case

• Main Authors: Bruno Besteiro, MD, Carina Teixeira, MD, Irene Gullo, MD, Sofia Pereira, MD, Miguel Almeida, MD, Jorge Almeida, MD
• Format: Article
• Language: English
• Published: Elsevier 2021-04-01
• Series: Radiology Case Reports
• Subjects: Superior Vena cava syndrome; Primary Mediastinal Large B-cell Lymphoma; Anterior mediastinal mass
• Online Access: http://www.sciencedirect.com/science/article/pii/S1930043321000637

The superior vena cava syndrome refers to a medical emergency resulting from superior vena cava compression, which develops in 2%-4% of non-Hodgkin lymphomas. Primary mediastinal (thymic) large B-cell lymphoma is an unusual and aggressive non-Hodgkin lymphoma that can present with superior vena cava syndrome.We report the case of a Caucasian 21-year-old female, who presented with acute superior vena cava syndrome, having started 2 weeks before. Chest computerized tomography disclosed an anterior mediastinal mass (18 × 14 cm). Thoraco-abdominopelvic magnetic resonance imaging was performed in order to differentiate compression versus mass invasion. A gross anterior mediastinal mass (109 × 60 × 105 mm) occupying the totality of the prevascular space was found, extending from the sternal furcula to the pericardium, fully embedding the superior vena cava. A computerized tomography guided biopsy was performed. Histopathological and immunohistochemical analysis was consistent with Primary mediastinal (thymic) large B-cell lymphoma.Primary mediastinal (thymic) large B-cell lymphoma has unique clinicopathologic aspects and it should be considered in a young patient with Superior vena cava syndrome. Prompt recognition, a timely diagnosis and appropriate treatment are crucial for prognosis.