Superior vena cava syndrome caused by systemic lupus erythematosus in a patient with longstanding rheumatoid arthritis.

Abstract

Superior vena cava syndrome is mostly related to a malignant process, but many different benign causes have also been described. We report a patient with longstanding classic rheumatoid arthritis (RA), who developed a superior vena cava syndrome due to mediastinal lymphadenopathy. At that time she also fulfilled the ARA criteria for systemic lupus erythematosus (SLE). Histological examination of a lymph node biopsy revealed necrosis, hematoxylin bodies and LE cells, while a great amount of amorphous proteinaceous material was seen positive with immunofluorescence for IgG, IgM and complement (C3 and Clq). A diagnosis of superior vena cava syndrome due to mediastinal lymphadenopathy in a patient with SLE which had evolved from longstanding RA was established.