Primary mediastinal B-cell lymphoma with superior vena cava (SVC) syndrome: facial/upper-...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-PMBCL-SVC-SYNDROME`
Type	Red flag
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Diseases	`DIS-PMBCL`
Sources	`SRC-ESMO-DLBCL-2024` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	Primary mediastinal B-cell lymphoma with superior vena cava (SVC) syndrome: facial/upper-extremity edema, distended neck veins, headache, plethora, dyspnea — class-defining presentation in PMBCL
Clinical direction	hold
Category	organ-dysfunction
Shifts algorithm	ALGO-PMBCL-1L

Trigger Logic

{
  "any_of": [
    {
      "finding": "svc_syndrome_present",
      "value": true
    },
    {
      "finding": "facial_upper_extremity_edema",
      "value": true
    },
    {
      "finding": "distended_neck_veins",
      "value": true
    },
    {
      "finding": "stridor_or_airway_compromise",
      "value": true
    }
  ],
  "type": "composite"
}

Notes

PMBCL median bulky mediastinal mass at diagnosis ~10-12 cm; SVC syndrome reported in 30-50% of PMBCL at presentation. Per NCCN B-cell PMBCL section: emergent dexamethasone 10 mg IV q6h pre-treatment; head elevation; consider venous stent if severe; biopsy-then-treat sequence may need to be compressed. Direction HOLD on definitive induction (DA-EPOCH-R or R-CHOP-RT) until SVC stabilized + airway secure. Priority 8. STUB — requires clinical co-lead signoff.

Used By

No reverse references found in the YAML corpus.