Superior vena cava syndrome induced by lung hyperinflation in chronic obstructive pulmonary disease: a case report
Abstract Background Superior vena cava syndrome is rarely attributed to chronic obstructive pulmonary disease. Case presentation We present the case of an 82-year-old Japanese man who experienced gradually progressive dyspnea on exertion. His physical examination revealed small vascular dilatations...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | https://doi.org/10.1186/s13256-023-04256-7 |
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| author | Nobuhiro Kanaji Naoki Watanabe Takuya Inoue Hitoshi Mizoguchi Kosuke Sakamoto Yuta Komori Kosuke Kawada Norimitsu Kadowaki |
| author_facet | Nobuhiro Kanaji Naoki Watanabe Takuya Inoue Hitoshi Mizoguchi Kosuke Sakamoto Yuta Komori Kosuke Kawada Norimitsu Kadowaki |
| author_sort | Nobuhiro Kanaji |
| collection | DOAJ |
| description | Abstract Background Superior vena cava syndrome is rarely attributed to chronic obstructive pulmonary disease. Case presentation We present the case of an 82-year-old Japanese man who experienced gradually progressive dyspnea on exertion. His physical examination revealed small vascular dilatations on his chest and upper abdominal skin characterized by blood flow from head to leg, indicating superior vena cava syndrome. Radiographic findings included lung hyperinflation with a drop-like heart on chest X-ray, and emphysematous changes on computed tomography. The superior vena cava appeared extremely narrow and slit-like, with no adjacent mass or giant bulla. Pulmonary function testing indicated a forced expiratory volume in 1 second of 0.82L (44.4% of predicted value) and a forced expiratory volume in 1 second/forced vital capacity of 31.29%. A diagnosis of chronic obstructive pulmonary disease was made. We discuss how longitudinal forces can narrow the superior vena cava, particularly when it protrudes toward the lung field due to its anatomical location in the upper mediastinum. The absence of mediastinal adipose tissue may render the superior vena cava susceptible to compression, resulting in a loss of its typical columnar structure. The protrusion of the superior vena cava toward the lung field may be a contributing factor to superior vena cava narrowing in chronic obstructive pulmonary disease. Conclusion This case represents the first reported instance of superior vena cava syndrome associated with chronic obstructive pulmonary disease, characterized by lung hyperinflation, in the absence of a giant bulla. |
| first_indexed | 2024-03-09T05:42:10Z |
| format | Article |
| id | doaj.art-586c2934c4a7464191afef4972129d54 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-03-09T05:42:10Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-586c2934c4a7464191afef4972129d542023-12-03T12:23:46ZengBMCJournal of Medical Case Reports1752-19472023-12-011711510.1186/s13256-023-04256-7Superior vena cava syndrome induced by lung hyperinflation in chronic obstructive pulmonary disease: a case reportNobuhiro Kanaji0Naoki Watanabe1Takuya Inoue2Hitoshi Mizoguchi3Kosuke Sakamoto4Yuta Komori5Kosuke Kawada6Norimitsu Kadowaki7Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa UniversityDivision of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa UniversityDivision of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa UniversityDivision of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa UniversityDepartment of Cardiovascular Surgery, Faculty of Medicine, Kagawa UniversityDivision of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa UniversityDivision of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa UniversityDivision of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa UniversityAbstract Background Superior vena cava syndrome is rarely attributed to chronic obstructive pulmonary disease. Case presentation We present the case of an 82-year-old Japanese man who experienced gradually progressive dyspnea on exertion. His physical examination revealed small vascular dilatations on his chest and upper abdominal skin characterized by blood flow from head to leg, indicating superior vena cava syndrome. Radiographic findings included lung hyperinflation with a drop-like heart on chest X-ray, and emphysematous changes on computed tomography. The superior vena cava appeared extremely narrow and slit-like, with no adjacent mass or giant bulla. Pulmonary function testing indicated a forced expiratory volume in 1 second of 0.82L (44.4% of predicted value) and a forced expiratory volume in 1 second/forced vital capacity of 31.29%. A diagnosis of chronic obstructive pulmonary disease was made. We discuss how longitudinal forces can narrow the superior vena cava, particularly when it protrudes toward the lung field due to its anatomical location in the upper mediastinum. The absence of mediastinal adipose tissue may render the superior vena cava susceptible to compression, resulting in a loss of its typical columnar structure. The protrusion of the superior vena cava toward the lung field may be a contributing factor to superior vena cava narrowing in chronic obstructive pulmonary disease. Conclusion This case represents the first reported instance of superior vena cava syndrome associated with chronic obstructive pulmonary disease, characterized by lung hyperinflation, in the absence of a giant bulla.https://doi.org/10.1186/s13256-023-04256-7EmphysemaChronic obstructive pulmonary diseaseSuperior vena cava syndromeCase report |
| spellingShingle | Nobuhiro Kanaji Naoki Watanabe Takuya Inoue Hitoshi Mizoguchi Kosuke Sakamoto Yuta Komori Kosuke Kawada Norimitsu Kadowaki Superior vena cava syndrome induced by lung hyperinflation in chronic obstructive pulmonary disease: a case report Journal of Medical Case Reports Emphysema Chronic obstructive pulmonary disease Superior vena cava syndrome Case report |
| title | Superior vena cava syndrome induced by lung hyperinflation in chronic obstructive pulmonary disease: a case report |
| title_full | Superior vena cava syndrome induced by lung hyperinflation in chronic obstructive pulmonary disease: a case report |
| title_fullStr | Superior vena cava syndrome induced by lung hyperinflation in chronic obstructive pulmonary disease: a case report |
| title_full_unstemmed | Superior vena cava syndrome induced by lung hyperinflation in chronic obstructive pulmonary disease: a case report |
| title_short | Superior vena cava syndrome induced by lung hyperinflation in chronic obstructive pulmonary disease: a case report |
| title_sort | superior vena cava syndrome induced by lung hyperinflation in chronic obstructive pulmonary disease a case report |
| topic | Emphysema Chronic obstructive pulmonary disease Superior vena cava syndrome Case report |
| url | https://doi.org/10.1186/s13256-023-04256-7 |
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