Histologic examination of a transbronchial biopsy

A 67-year-old man complains of shortness of breath, hoarseness, productive cough, and bloody sputum of 2 weeks in duration. He admits to smoking two packs a day for 45 years and drinks occasionally. Recently, he has experienced a significant loss of appetite and weight loss. Physical examination shows pallor, cachexia, clubbing of the fingers, and barrel-shaped chest. A chest X-ray reveals a mass at the right lung apex. Histologic examination of a transbronchial biopsy is shown in the figure. What is the appropriate histologic diagnosis?

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  1. Adenocarcinoma
  2. Mesothelioma
  3. Metastatic adenocarcinoma
  4. Small cell carcinoma
  5. Squamous cell carcinoma