An area of increased activity in segment IV of liver (quadrate lobe) on 99mTc-sulfur colloid (TSC)
scans has been well documented in patients with superior vena cava obstruction. Similarly intense
enhancement of the quadrate lobe in the arterial phase may be seen on computed tomography in
patients of superior vena cava syndrome. We present this imaging finding in a case of malignant
thymoma causing superior vena cava syndrome and discuss the physiological cause and importance
of this sign.