Fig. 1Visible collateral veins in the abdomen and chest wall.
Fig. 2Contrast-enhanced thoracic computed tomography reveals an obstruction of the superior vena cava (SVC) (A, white arrow) and a narrowed right azygous vein (B, white arrow), resulting in numerous collateral vessels, including bilateral brachiocephalic and subclavian veins with numerous collaterals (C, multiple thin white arrows). Pneumonia in the right-middle and lower lobes and a combined hemorrhage underlying early interstitial fibrosis are visible at the base of both lungs (D, black arrow).
Fig. 3Bronchial varices found on bronchoscopic examination. Bronchial veins are linearly dilated in the right-middle and lower bronchi (white arrows). The bronchial mucosa was edematous and bled easily after being touched by the bronchoscope.
Fig. 4Follow-up bronchoscopy after four cycles of high dose cyclophosphamide showing slightly regressed saccular-form varices in the right-middle and right-lower bronchi, compared with findings from the initial bronchoscopic exam.