Other diagnostic studies in the evaluation of superior vena cava syndrome include sputum tests, bronchoscopy, and biopsy. In addition, invasive contrast venography is also a diagnostic tool in the diagnosis of superior vena cava syndrome. It may be useful on the etiology of obstruction and exact location of the obstruction, also helpful in the surgical management of the obstructed vena cava.

If bronchogenic carcinoma is suspected, a sputum specimen should be obtained. If the sputum specimen is negative, a biopsy specimen should be taken from the most accessible site that is clinically involved with disease.^[1]

A bronchoscopy (a lighted tube placed through the mouth into the windpipe and lungs) may be performed if lung cancer is suspected.

The biopsy approach depends on the working diagnosis, the location of the tumor, the physiologic status of the patient, and the expertise available at the facility. It may include bronchoscopy, biopsy of palpable cervical or supraclavicular lymph nodes, needle biopsy of a lung mass or mediastinal nodes using either CT or ultrasound guidance, mediastinoscopy, mediastinotomy, median sternotomy, video-assisted thoracoscopy, and conventional thoracotomy. The biopsy findings will help the clinician plan appropriate treatment.

Invasive contrast venography may be useful on the etiology of obstruction and exact location of the obstruction, also helpful in the surgical management of the obstructed vena cava.^[1]