Classic radiographic appearance of multiple myeloma is that of multiple, small, well-circumscribed, lytic, punched-out, round lesions within the skull, spine, and pelvis. Lesions are lytic without reactive bone formation because of tumor factors that combine to activate osteoclasts and inhibit osteoblasts. The lesions tend to vary slightly in size. from @medical_way
Its so interesting watching the medical resolutions on this rare disease.