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This previously healthy 65 y/o female presented with headache and facial swelling and was referred for Chest CT. Selected images, obtained during the rapid I.V. administration of contrast, are shown above. Even without the additional information subsequently provided by physical exam (venous engorgement of the face and neck), the diagnosis of Superior Vena Cava Syndrome should be obvious on this CT scan. The marked collateral venous flow should immediately suggest this diagnosis. Extrinsic compression of the SVC by mass or adenopathy is easily seen on these images. The pathologic etiology of this compression can only be established by biopsy. In this case, small cell carcinoma was diagnosed.

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