multiple myeloma lytic lesionslytic lesion causeslytic bone lesions multiple myelomacauses of osteolytic bone lesionspunched out lytic lesionsmultiple myeloma osteolytic lesionspunched out lytic bone lesionsbone lesions in multiple myelomamultiple myeloma punched out lesionsosteolytic lesion causesmultiple osteolytic lesionslytic lesions myeloma