A 65-Year-Old Man Comes to the Office for Evaluation of Blood

A 65-year-old man comes to the office for evaluation of blood in the urine.  The patient has no abdominal pain, urinary frequency, or urgency.  He has hypertension, type 2 diabetes mellitus, and stage II chronic kidney disease.  He quit smoking 10 years ago and had smoked a pack of cigarettes daily for 30 years. Laboratory evaluation shows a hematocrit of 56%.  Chest imaging shows multiple round lesions in both lungs.  Biopsy of one of the lesions reveals the microscopic findings shown below. This patient's metastatic disease most likely originated from which of the following organs?

A) Bone
B) Brain
C) Colon
D) Kidney
E) Stomach
F) Testis

Correct Answer:

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