Tanaka M, Komatsu S, Rikimaru T, Tomita Y, Yano T, Ichikawa Y, Oizumi K, Edakuni S
First Department of Internal Medicine, Kurume University School of Medicine.
Kansenshogaku Zasshi. 1991 Mar;65(3):344-8. doi: 10.11150/kansenshogakuzasshi1970.65.344.
Superior vena cava (SVC) syndrome caused by benign diseases is rare. We reported a case of mediastinal abscess due to Enterococcus faecalis (E. faecalis) accompanied with SVC syndrome and reviewed the literature on this particular condition. A 38-year-old female with swelling of the neck and dilatation of cervical vein was admitted to our hospital, being diagnosed as having a SVC syndrome. Chest roentgenogram revealed an enlargement of the right upper mediastinum and a massive infiltration in the right upper lung field. CT scan demonstrated a mass with central necrosis occupying the right upper mediastinum and stenosis of superior vena cava. Further conformation of the stenosis of vena cava was made by means of venography. E. faecalis was recovered from the pus aspirated from the mediastinal abscess, and a definitive diagnosis of SVC syndrome caused by mediastinal abscess due to E. faecalis was made. There has been no report, to our knowledge, on mediastinal abscess evolving SVC syndrome in which E. faecalis was identified as a causative organism. The present case indicates that a benign disease such as lung abscess should be considered to be a possible cause of SVC syndrome in addition to other frequent malignant diseases.
由良性疾病引起的上腔静脉（SVC）综合征较为罕见。我们报告了一例因粪肠球菌导致的纵隔脓肿伴发SVC综合征的病例，并对有关这一特殊情况的文献进行了综述。一名38岁女性因颈部肿胀和颈静脉扩张入住我院，被诊断为患有SVC综合征。胸部X线片显示右上纵隔增宽及右上肺野大片浸润。CT扫描显示一个中央坏死的肿块占据右上纵隔并导致上腔静脉狭窄。通过静脉造影进一步证实了腔静脉狭窄。从纵隔脓肿抽出的脓液中培养出粪肠球菌，最终诊断为由粪肠球菌引起的纵隔脓肿导致的SVC综合征。据我们所知，尚无关于由粪肠球菌作为病原体导致纵隔脓肿并发SVC综合征的报道。本病例表明，除了其他常见的恶性疾病外，诸如肺脓肿这样的良性疾病也应被视为SVC综合征的可能病因。
