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A 69-yrs-old man with a 60 pack-year history for smoking presents with dizziness and visual disturbances. Physical examination reveals a purplish discoloration of his face, arms, and neck; retinal vein engorgement; and visible distention of his neck veins. His complete blood count reveals a normocytic anemia. The pathophysiology of this patient’s clinical presentation most likely involves.

ARight heart failure secondary to left heart failure
BObstruction of the superior vena cava by a primary tumor arising in the lungs
CMetastatic disease to the cervical lymph nodes with compression of the jugular veins
DPolycythemia rubra vera
Unknown
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