Haematology
Case 15: A Patient with Shortness of Breath and Cough
CASE
A 31‐year‐old man presents to A&E with a 3‐week history of increasing shortness of breath and cough when he lies flat. He now has to sleep with six pillows. He has also unintentionally lost 4 kg in weight over the last 2 months and his appetite is poor. He is not complaining of any night sweats or fevers. On examination, he has fixed distended neck veins and respiratory examination reveals stony dullness with reduced breath sounds in the right lung base. Cardiovascular and abdominal examination is unremarkable.
Routine blood tests and an ECG are all normal. Chest X‐ray shows a large mediastinal mass measuring 12 cm in transverse diameter.
QUESTION 1
Your score this session: 0 of 0
What is the significance of the fixed distended neck veins?