Multiple coin shaped lesions in a person who is apparently critical ( I can spot a wire entering the heart ). So my first impression is - Secondary mets to lung. Now if this patient was relatively symptom free - I would go for Alveolar Sarcoidosis ( a rare form of sarcoidosis which resembles lung mets ) Can't b miliary tb as it will hav a more finer reticulo-nodular pattern. Can't b multiple myeloma, as those would be lytic lesions, limited to the ribs. (-:
