Review Question - QID 108944

A 65-year-old Asian male presents to the emergency department complaining of shortness of breath. He reports a three-month history of progressively worsening shortness of breath and cough. One week ago, he started noticing blood in his handkerchief whenever he coughed. The patient immigrated from China ten years ago and has a history of tuberculosis as an adolescent. His medical history is also notable for alcohol abuse and alcoholic liver disease. He worked for many years as a dockworker in China. His temperature is 101.5°F (38.7°C), blood pressure is 130/70 mmHg, pulse is 115/min, and respirations are 20/min. Physical examination reveals rales in the right middle lung field. A chest CT of the patient is shown in Figure A. A biopsy of this lesion would likely reveal which of the following?