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Detection of a venous collateral pathway by mammography: superior vena caval syndrome.

THE SYNDROME of superior vena caval syndrome (SVCS) may be associated with a variety of patterns of collateral circulation. We report the case of a patient with SVCS who had a unique route of collateral circulation consisting of a superficial breast vein discovered in the course of routine mammography. This finding provided a clue to the cause of a mediastinal pseudotumor in the chest roentgenogram that resulted from dilation of the left superior intercostal and accessory hemiazygous veins. Report of a Case In 1970 a 35-year-old woman entered the emergency room of the Hospital of the University of Pennsylvania with chief complaint of swelling in the left axilla for two days. A chest x-ray showed a mediastinal mass, and the patient was admitted for further study. Additional history included tightness in the throat and anterior superior chest wall for approximately one year, mild shortness of breath on exertion, and intermittent