A 67 Year Old Man,with a Known History of Inoperable

A 67 year old man,with a known history of inoperable pancreatic adenocarcinoma,suddenly developed symptoms of a massive stroke,losing the ability to walk.He subsequently died from cerebral oedema,and the family requested an autopsy.In the accompanying low power photomicrograph of a mitral valve leaflet (L) ,the thrombus (T) attached to the leaflet was probably caused by which one of the following pathophysiologic conditions?

A) Anaemia
B) Biliary obstruction by tumour
C) Diabetes mellitus
D) Fever
E) Hypercoagulable state A.Shock