A 68-Year-Old Man Comes to the Office Due to Persistent

A 68-year-old man comes to the office due to persistent back pain for the past several months.  He is a retired veteran and has not seen a doctor for many years.  He has smoked a pack of cigarettes daily for 36 years.  His blood pressure is 145/85 mm Hg and pulse is 88/min and regular.  Cardiopulmonary examination is unremarkable.  The abdomen is soft and nontender.  There is focal tenderness over the 10th rib and L1-L2 vertebral region.  Neurologic examination is normal.  Radionuclide bone imaging reveals increased activity in multiple vertebrae and ribs, corresponding to the patient's painful areas.  Routine radiographs show sclerotic lesions matching the bone scan areas of increased uptake, which are highly suspicious for metastatic cancer.  Which of the following additional findings is most likely to be seen in this patient?

A) Hematuria and polycythemia
B) Monoclonal immunoglobulin spike
C) Lung mass and elevated parathyroid hormone-related peptide
D) Lymphadenopathy and BCL-2 overexpression
E) Nodular prostate and elevated prostate-specific antigen level
F) Rapidly enlarging, large, irregular mole

Correct Answer:

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