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Click 68 year old woman with metastatic pancreatic cancer to liver and spine. Followup CT exam (Siemens Sensation 64, 120 kVp, 350 mAs, 5 mm and 0.75 mm slice thickness, 100 ml Omnipaque 320, venous phase of abdomen and arterial chest) of the chest, abdomen, and pelvis demonstrates extensive heterogenous hypodense irregular masses throughout liver, consistent with metastatic disease. A 1.7 x 2.8 cm mass in pancreatic tail, consistent with primary tumor is seen. Heterogenous perfusion to the spleen is also seen, related to new splenic artery occlusion and/or chronic splenic vein occlusion. 5.7 x 2 cm target lesion in inferior aspect of spleen is also seen. Filling defect is seen in dilated right ovarian vein, measuring up to 8 mm, compared to the right, consistent with thrombus. Clot is also well seen on coronal reformatted images, after axial images. Numerous sclerotic metastatic lesions are seen throughout spine. Last axial images of the chest are magnified to demonstrate subtle filling defect in right inferior pulmonary arterial branch, consistent with pulmonary embolism.