一位68歲女性被發現有蛋白尿,抽血檢查顯示血紅素8.7 gm/dL,白血球及血小板正常,白蛋白3.3 gm/dL,球蛋白1.8 gm/dL,Cr 1.7 mg/dL,尿中Bence-Jones protein陽性,頭部X-光如圖所示。此病人最可能的診斷為?
multiple myleoma
carcinoma with bone metastasis
anemia secondary to chronic kidney disease
Paget’s disease