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40. A 47-year-old man comes to the physician because of a 3-week history of increasing facial swelling and a 1-week history of morning headaches and mild shortness of breath. He had previously felt well. He completed a course of chemotherapy 4 months ago for small cell carcinoma of the lung. His temperature is 37.2°C (98.9°F), blood pressure is 142180 mm Hg with an 8-mm Hg paradoxical pulse, pulse is 84/min, and respirations are 18/min. Examination shows significant diffuse facial and periorbital edema. The optic discs are sharp, and ocular movements are intact. The lungs are hyperresonant bilaterally with a moderately prolonged expiratory phase. Mild rhonchi are heard on inspiration and expiration. An x-ray film of the chest shows a 10-cm mass in the right upper lobe and apex. Which
of the following is the most likely explanation for these findings?
O A) Chemotherapy-induced bone marrow toxicity
O B) Chemotherapy-related cardiac toxicity
O C) Hypercoagulable state secondary to malignancy
O D) Interstitial metastatic pulmonary disease
O E) Intracranial metastases
O F) Lymphatic obstruction
O G) Malignant pericarditis
O H) Paraneoplastic syndrome
O I) Pleural metastases
O J) Soft tissue metastases
0 K) Vascular obstruction

kk

vascular obstruction....its simple to guess

@michael,,aaz plz explain

hey michael is that svc???!!!

All si/sx of svc obstruction...so its a vascular obs

thnx aaz,,,,,,,,,

yeah very right its svc

and diagnosis is knwn as pancoast tumor or superior sulcus tumor

yes this is svc and diagnosis is pancoast tumor or superior sulcus tumor

yes it is svc and diagnosis is superior sulucs tumor also knwn as pancoast syndrome leading to compression of blood vessels and sometimes recurrent laryngeal nerve as well leading to hoarsnesss