Pemberton's sign

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Pemberton's sign is the development of facial plethora, distended neck and head superficial veins, inspiratory stridor and elevation of the jugular venous pressure (JVP) upon raising of the patient's both arms above his/her head simultaneously, as high as possible (Pemberton's maneuver).

A positive Pemberton's sign is a sign of superior vena cava syndrome, possibly from a mass in the mediastinum, usually caused by a tumor or goiter (thoracic inlet obstruction due to retrosternal goitre or mass).

Apical lung cancers often cause a positive Pemberton's sign and a high index of suspicion should be maintained in patients with symptoms of dyspnea and facial plethora with an extensive smoking history.