Step 1: The differential for a lytic (bone-destroying) lesion is captured by the mnemonic FOG MACHINES: Fibrous dysplasia or fibrous cortical defect, Osteoblastoma, Giant cell tumour, Metastases and Myeloma, Aneurysmal bone cyst, Chondroblastoma or chondromyxoid fibroma, Hyperparathyroidism brown tumour, Infection, Non-ossifying fibroma, Enchondroma or eosinophilic granuloma, and Simple bone cyst.
Step 2: Multiple myeloma is a classic cause of lytic lesions and the solitary form, a plasmacytoma, presents as a single lytic bone lesion. So it fits the question directly.
Step 3: The other choices are not bone-lytic processes. Atherosclerosis and mitral stenosis are cardiovascular conditions, and osteoblast is a bone-forming cell rather than a disease that destroys bone.
Step 4: Hence the correct answer is multiple myeloma, option b.