Large mixed lytic and sclerotic bony lesion seen involving most of the shaft of the right femur causing cortical destruction with bone marrow infiltration seen. There is aggressive lamellated and sunburst type periosteal reaction, with huge soft tissue component containing areas of necrosis and osseous calcified matrix seen involving most of the thigh reaching up to the right hip joint and down to the right knee joint. It wraps around the femur and the neurovascular bundle measuring about 42.4 x 22.5 x 18.3 cm representing the patient's known osteosarcoma.
There are innumerable variable size and randomly distributed bilateral pleural-based and intraparenchymal lung nodules most of which contain areas of calcifications. Findings are in keeping with calcified lung metastasis from the patient's known osteosarcoma.
Pathologically enlarged, necrotic and matted right external iliac lymph nodes are seen, containing foci of calcification in keeping with metastatic lymph nodes from the patient's known osteosarcoma.