If cancer cells are carried in the venous drainage, they would travel fi rst to which of the following veins?

A 62-year-old woman who is a heavy smoker has an advanced lung cancer that
spread into her right third intercostal space posterior to the midaxillary line. If cancer cells
are carried in the venous drainage, they would travel fi rst to which of the following veins?

(A) SVC
(B) Right superior intercostal vein
© Right brachiocephalic vein
(D) Azygos vein
(E) Hemiazygos vein

The answer is B. The superior intercostal vein is formed by the union of the second, third,
and fourth posterior intercostal veins and drains into the azygos vein on the right and the
brachiocephalic vein on the left. The azygos vein drains into the SVC. The hemiazygos vein
usually drains into the azygos vein.