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6481 Pathology

A 13-year-old, previously healthy boy has had pain in the right leg for the past month. There is no history of trauma or recent illness. On physical examination, there is warmth and tenderness to palpation of the right lower thigh anteriorly, and the circumference of the right thigh is slightly larger than that of the left. His temperature is 39degC. A radiograph of the right leg shows a 6-cm expansile mass in the diaphyseal region of the right lower femur that extends into the soft tissue and is covered by layers of reactive bone. A biopsy of the mass is done, and microscopic examination shows sheets of closely packed primitive cells with small, uniform nuclei and only scant cytoplasm. Karyotypic analysis of the tumor cells shows a t(11;22) translocation. What is the most likely diagnosis?

AChondrosarcoma
BEwing sarcoma
CGiant cell tumor
DMetastatic carcinoma
Pathology
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