This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Radiology
76 year old man presents with a lytic lesion in the vertebrae. X-ray skull showed multiple punched out lesions. The diagnosis is – 
Select and explain. 
A. Metastasis, B. Multiple myeloma, C. Osteomalacia, D. Hyperparathyroidism
B: Multiple myeloma
Answer: B: Multiple myeloma 
Explanation: Punched out lesions of skull are seen both in Eosinophilic granuloma and multiple myeloma. However, beveled edges (double contour) is characteristic of eosinophilic granuloma due to uneven destruction of the inner and outer table of the skull.

          Punched out lesions of skull                    →  Multiple myeloma
          Punched out lesions with beveled edges   →  Eosinophilic granuloma