77 Lung Cancer: Small Cell Carcinoma

Clinical Presentation

60-year-old woman with facial swelling and weight loss

Radiologic Findings

PA (Fig. 77.1) and lateral (Fig. 77.2) chest radiographs demonstrate a mediastinal mass of lobular contours that extends to both sides of midline and is predominantly located in the anterior mediastinum (Fig. 77.2). Note the small right pleural effusion. Contrast-enhanced chest CT (mediastinal window) (Figs. 77.3, 77.4) demonstrates extensive mediastinal lymphadenopathy encasing the great vessels and the central tracheobronchial tree as well as a small right pleural effusion. Note the almost complete obliteration of the lumen of the superior vena cava (Fig. 77.4), enhancing chest wall collateral vessels (arrow) (Fig. 77.3), and intense enhancement of the azygos vein (Fig. 77.4), consistent with superior vena cava obstruction.