A 65-Year-Old Woman Has Had Several Months of Progressive Fatigue

A 65-year-old woman has had several months of progressive fatigue, diminished appetite, and unintentional weight loss.  The patient has no chronic medical conditions.  She has not received medical care in many years and has not had recommended cancer screening.  The patient suddenly dies while undergoing evaluation.  Autopsy reveals abnormal liver findings, as shown in the exhibit below. Microscopic evaluation of the lesions reveals neoplastic cells.  Which of the following is the most likely cause of this patient's liver lesions?

A) Lymphatic spread of a malignancy
B) Malignancy metastasizing via the hepatic veins
C) Malignancy spreading through the portal circulation
D) Primary neoplastic transformation of hepatocytes
E) Transcoelomic spread of a malignancy

Correct Answer:

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