[2] The Pemberton maneuver is achieved by having the patient elevate both arms (usually 180 degrees anterior flexion at the shoulder) until the forearms touch the sides of the face.
A positive Pemberton's sign is marked by the presence of facial congestion and cyanosis, as well as respiratory distress after approximately one minute.
[3] A positive Pemberton's sign is indicative of superior vena cava syndrome (SVC), commonly the result of a mass in the mediastinum.
SVC syndrome has been observed as a result of diffuse mediastinal lymphadenopathy of various pathologies such as cystic fibrosis[5] and Castleman’s disease.
[6] Park et al. reported enlarged cervical lymph nodes associated with hemophagocytic lymphohistiocytosis as the cause of internal jugular vein compression, which presented clinically similar to SVC syndrome.