A 15-Year-Old Boy Is Brought to the Emergency Department Due

A 15-year-old boy is brought to the emergency department due to hemoptysis.  He has a history of amputation of the right lower extremity for "bone cancer" in Mexico.  Chest imaging reveals a lung mass.  Excisional biopsy of the mass shows sheets of uniform, small (slightly larger than lymphocytes) , round cells with scant, clear cytoplasm.  The cellular deposits are interrupted by vascular fibrous septae, with areas of hemorrhage and an abrupt transition from viable to necrotic cells.  A representative sample is shown in the image. Which of the following is the most likely diagnosis?

A) Adenocarcinoma
B) Chondrosarcoma
C) Ewing sarcoma
D) Multiple myeloma
E) Osteosarcoma

Correct Answer:

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