A 60-year-old man has been found to have small cell lung cancer on the basis of results of…

A 60-year-old man has been found to have small cell lung
cancer on the basis of results of bronchoscopic biopsy findings. Computed
tomography (CT) scan of the chest shows extensive mediastinal adenopathy. The
patient has been admitted to the oncology floor for chemotherapy. You are
called to assess him because he cannot lie down owing to shortness of breath
(orthopnea). When you arrive, the patient is sitting on the edge of the bed.
You notice that his face and neck are swollen. He also has dilated veins over
the face, neck, chest, and arms. How do you explain these findings?

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