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Bones, but no moans or stones

Case Identification
Case ID Number: 
20090728BB
Benign/Malignant: 
unknown
Clinical case information
Case presentation: 

A 58 year old woman has multiple lesions in multiple bones. She complains of "achy bones". She is weak, and has been confused and forgetful recently.

Laboratory results:: 
A CBC shows anemia.
Special Features of this Case:: 
What is the diagnosis? Why is the patient confused? What is the cause of the renal failure?
Image Reference: