Figure 11d. Massive PE, dilatation of the right side of the heart with septal flattening, incidentally discovered lung cancer, and multiple paraneoplastic venous thromboses in a 61-year-old woman who presented with increasing dyspnea and alteration of her general condition. The pathologic conditions were diagnosed with combined CT pulmonary angiography–CT venography. (a–d) Axial CT pulmonary angiograms obtained with a 16-detector-row scanner show the following findings: multiple PEs in the segmental PAs of both lower lobes and the middle lobe (arrows in a); a lung carcinoma in the left upper lobe (arrowhead in b); thrombi in the left innominate and left subclavian veins (arrow in b, arrows in c); and an RV that is dilated relative to the LV with associated flattening of the interventricular septum (arrowhead in d). (e–g) Axial CT venograms show multiple venous clots in the right great saphenous vein (arrow in e), left popliteal vein (arrow in f), and bilateral tibioperoneal trunks (arrows in g).