Question

what diagnosis can present with multiple punched out osteolytic lesions of approximately the same size and shape? a) paget disease b) lymphoma c) multiple myeloma d) metastasis

Explanation:

• Paget disease typically causes enlarged, deformed bones with mixed lytic and sclerotic changes, not uniform punched-out lesions.
• Lymphoma bone lesions are usually solitary or have variable, non-uniform lytic/sclerotic features.
• Multiple myeloma is characterized by monoclonal plasma cell proliferation that creates multiple, well-circumscribed, punched-out osteolytic lesions of nearly identical size and shape.
• Metastatic bone lesions are typically variable in size, shape, and distribution, often with mixed lytic or blastic features depending on the primary tumor.

Answer:

C) multiple myeloma