Pemberton's sign is the development of facial flushing

Flushing (physiology)

For a person to flush is to become markedly red in the face and often other areas of the skin, from various physiological conditions. Flushing is generally distinguished, despite a close physiological relation between them, from blushing, which is milder, generally restricted to the face, cheeks or...

, distended neck and head superficial veins, inspiratory stridor

Stridor

Stridor is a high pitched wheezing sound resulting from turbulent air flow in the upper airway. Stridor is a physical sign which is produced by narrow or obstructed airway path. It can be inspiratory, expiratory or biphasic . Inspiratory stridor is common...

 and elevation of the jugular venous pressure

Jugular venous pressure

The jugular venous pressure is the indirectly observed pressure over the venous system...

 (JVP) upon raising of the patient's both arms above his/her head simultaneously, as high as possible (Pemberton's maneuver).

It is named for Dr. Hugh Pemberton

Hugh Pemberton

Hugh Spear Pemberton was an English physician remembered for describing Pemberton's sign.- Biography :Hugh Pemberton qualified MB ChB from the University of Liverpool in 1913 and started working at the David Lewis Northern Hospital in Liverpool...

, who characterized it in 1946.

Causes

A positive Pemberton's sign is a sign of superior vena cava syndrome

Superior vena cava syndrome

Superior vena cava syndrome , or superior vena cava obstruction , is usually the result of the direct obstruction of the superior vena cava by malignancies such as compression of the vessel wall by right upper lobe tumors or thymoma and/or mediastinal lymphadenopathy. The most common malignancies...

, possibly from a mass in the mediastinum

Mediastinum

The mediastinum is a non-delineated group of structures in the thorax, surrounded by loose connective tissue. It is the central compartment of the thoracic cavity...

, such as a tumor

Tumor

A tumor or tumour is commonly used as a synonym for a neoplasm that appears enlarged in size. Tumor is not synonymous with cancer...

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.