[Upper inflow congestion as initial manifestation of idiopathic mediastinal fibrosis]

In about 90% of superior vena caval obstructions the cause is a neoplasm, generally a carcinoma of the right upper lobe. Fewer than 5 percent are due to inflammatory disease of the mediastinum. A case of idiopathic, fibrosing mediastinitis with occlusion of the superior vena cava is described. The clinical symptoms, radiographic finding, diagnostic and therapeutic aspects are discussed.