One of the common causes of superior vena cava (SVC) syndrome is malignancy of the
lung. The invasion of SVC leads to opening of the various venous channels for continuation
of the blood flow from upper extremity and proximal trunk and finally draining into
right atrium. Vein of Sappey is one of these channels and it causes focal striking
enhancement in segment IV of the liver on arterial phase of contrast computed tomography
(CT). This enhancement causes diagnostic difficulty and unnecessary biopsy due to
misinterpretation of it as a secondary from lung cancer. Awareness and accurate diagnosis
can avoid further examination in such patients. It can also provide an idea of a more
proximal major thoracic vessel obstruction iffirst detected on CT of the abdomen (contrast).
Keywords
Bronchogenic carcinoma - pseudolesion - superior vena cava syndrome - vein of Sappey