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©2013 UpToDate ® Print Email CT blastic lytic and mixed metastases The reconstructed CT images are from three different patients and reflect different patterns of metastatic bone disease. The bone windows of the spine are projected as sagittal reconstructions. The first (A) is a patient with breast carcinoma complicated by blastic metastatic disease of the thoracolumbar spine (white arrow). The second (B) is a patient with multiple myeloma and multiple lytic lesions in the thoracolumbar spine (red arrow). The third (C) is a patient with breast carcinoma with both blastic (white arrow) and lytic (red arrow) disease.