CTICasesAnaplastic Large Cell Lymphoma
Imaging findings
Chest CT shows a large anterior mediastinal mass, a large right pleural effusion, and complete obstruction of the superior vena cava (SVC) with prominent collateral venous pathways (superior intercostal, paravertebral, and capsular veins). An atypical venous collateral-induced hotspot is seen in the posterior liver.
Key takeaways
Superior vena cava obstruction by mediastinal malignancies (such as ALK-negative anaplastic large cell lymphoma) leads to extensive venous collateralization, which can cause focal hepatic enhancement (hotspot sign) in atypical segments.
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