上腔靜脈症候羣：一病例報告

Superior Vena Cava Syndrome: Report of a Case

張炳煌(Bin-Fong Chang) ； 洪焜隆(Kun-Long Hung) ； 王南焜(Nan-Koowg Wang) ； 陳德輝(Tou-Hwei Chen) ； 黃錫信(Shi-Shin Huang)

《Acta Paediatrica Sinica》 29卷5期 (1988/10) Pp. 357-362

摘要

上腔靜脈症候羣是由於上腔靜脈阻寒所引起的臨床症候羣。在成人並不少見，但在小孩卻很少見。本文為一個十歲男童，主訴住院十天前出現臉部浮腫、眼瞼水腫、頸部、胸部表層靜脈充血、咳嗽及呼吸急促現象。經上腔靜脈攝影檢查、胸部電腦斷層及心臓超音波檢查，顯示因縱膈腔腫瘤完全壓迫到上腔靜脈所致。病理切片診斷為淋巴芽球淋巴瘤。因在小兒科極為少見，特就其臨床表現、實驗室檢查等並參考文獻，提出報告。

並列摘要

Superior vena cava syndrome (SVCS), whether partial or complete, is a clinical and pathological entity due to various degrees of obstruction of the superior vena cava (SVC). The first case of SVCS was reported in 1757 by Hunter. In that patient, the obstruction was secondary to a syphilitic aortic aneurysm.
The occurrence of SVCS in childhood is rare, largely neglected by pediatricians, surgeons and cardiologists.
Recently, we found a 10-year-old boy with SVCS. He suffered from cough, dyspnea, edema of the face and eyelides as well as superficial venous engorgement of the neck, chest and upper abdomen. On admission the chest x-ray film showed a large mass shadow over the right lung field and right pleural effusion. The echocardiography revealed a mass that occupied the junction of SVC and right atrium. The chest C-T scan showed a mass in the anterior mediastium without involvemnet of the lung and heart. The venography showed a complete obstruction of SVC and collateral circulation of the superficial veins. The aspiration of anterior mediastinal tumor showed the picture of lymphoblastic lymphoma. After one course of chemotherapy: cyclophosphamide, adriamycin, vincristine and prednisolone (CHOP), the tumor mass disappeared and the symptoms and signs of SVCS subsided.

並列關鍵字

superior vena cava syndrome ； venography ； mediastinal tumor ； lymphoblastic lymphoma