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Irregular mass in the right lung apex (arrow) is associated with a large right adrenal mass lesion with central low density indicative of necrosis (arrow). Right lung base is clear. Subsequent CTPA shows marked right lung atelectasis with pleural fluid with a dramatic increase in size of the metastasis with central high denisty indicative of haemorrhage (arrow). This explains the right sided pleuritic symptoms and hypotension. No signs of PE.