A 50-Year-Old Man Comes to the Clinic for Evaluation Prior

A 50-year-old man comes to the clinic for evaluation prior to a left total knee arthroplasty.  Medical history is significant for osteoarthritis.  The patient does not smoke.  Preoperative chest x-ray demonstrates a 1.5-cm, round lesion in the periphery of the right upper lobe of the lung.  Further imaging studies are suggestive of a pulmonary hamartoma.  If a transthoracic biopsy were performed, which of the following microscopic features would be most consistent with this diagnosis?

A) Atypical cells lining alveoli without invasion
B) Expression of neuroendocrine markers
C) Invasive nests with keratin pearl formation
D) Nodules of cartilaginous tissue
E) Sheets of large pleomorphic cells

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