PMC4531936_01
Chest radiography shows slightly widened superior mediastinum and laterally shifted dome of the right hemidiaphragm.
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Chest radiograph revealed a slightly widened superior mediastinum, suggesting a pathologic problem of the supenor mediastinum(Fig. 1).
Initial contrast enhanced CT scan shows filling defect in the superior vena cava suggesting thrombosis (long arrow) and rich collateral veins in the mediastinum(arrow head) and chest wall. Pleural effusion is seen in the right hemithorax.
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Initial computed tomography(CT) scan, following a bolus injection of intravenous contrast medium, demonstrated obstruction of the superior vena cava with thrombosis and pleural effusion of the right hemithorax(Fig. 2).
Follow-up CT after 3 months from initial CT scan shows newly developed consolidation in the left posterior basal segment(long arrow). The pleural effusion in the right hemithorax is decreased.
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Follow-up CT scan demonstrated decreased pleural effusion, but newly developed consolidation at the left lower lobe territory, 3x1.5x3cm size in diameter, suggested focal pulmonary infarction(Fig. 3).
Double contrast colon study shows ileocecal fistula and irregular shaped cecal ulceration.
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The colon study and colonoscopy revealed solitary cecal ulcer with an irregular mucosal change of the ileocecal area and ileocecal fistula(Fig. 5).