What can be a characteristic radiological finding in Multiple Myeloma?

In Multiple Myeloma, one of the hallmark radiological findings is the presence of "punched-out" lesions in the skull and other bones. These lesions are a result of the osteolytic activity induced by the myeloma cells, which lead to local bone destruction. The radiological appearance of these osteolytic lesions resembles small holes or "punched-out" areas, particularly within the skull, spine, pelvis, and ribs.

This characteristic finding helps differentiate Multiple Myeloma from other conditions that affect bone and can be a crucial aspect of its diagnosis. Radiologists often look for these lesions when Multiple Myeloma is suspected, as they reflect the underlying pathology of the disease related to plasma cell proliferation and bone marrow infiltration.

The other options, while related to different conditions or aspects of pathology, do not specifically relate to the defining features of Multiple Myeloma. For example, butterfly vertebrae are more commonly associated with congenital spine anomalies rather than myeloma. Massive pleural effusion can occur in a variety of conditions but is not a diagnostic characteristic of Multiple Myeloma. Diffuse infiltrative shadows might suggest various pulmonary conditions but do not specifically indicate myeloma-related changes.