A 77-Year-Old Man Is Brought to the Emergency Department Due

question 262

Multiple Choice

A 77-year-old man is brought to the emergency department due to acute-onset chest pain, shortness of breath, and syncope.  Medical history is significant for coronary artery disease, which was treated with right coronary artery stenting 5 years ago.  The patient develops cardiac arrest and resuscitation is unsuccessful.  Autopsy shows a large bilateral pulmonary embolism occluding the pulmonary trunk.  Further history obtained from the patient's wife indicates that he has had constant back pain over the past few months.  Autopsy of the vertebrae is shown in the image below: Histologic examination of the bone lesions in this patient would most likely show which of the following?

• A)Aggregates of pleomorphic neoplastic cells containing coarse, brown pigment
• B)Cells with enlarged nuclei and prominent nucleoli forming irregular glands
• C)Effacement of bone marrow with clusters of plasmablasts and plasma cells
• D)Sheets of neoplastic cells with abundant clear cytoplasm
• E)Tumor cells showing a complex papillary pattern and psammoma bodies

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