Hepatocellular carcinoma usually metastasizes to regional abdominal lymph nodes. Distant lymph nodal metastases are relatively rare with most common extra abdominal sites being mediastinum and juxtaphrenic regions. Metastasis to internal mammary lymph nodes is extremely rare, and we present a case of hepatocellular carcinoma with histopathologically proven internal mammary lymph nodal metastasis in the absence of regional abdominal lymph nodal metastases.
T-cell large granular lymphocytic leukemia is a rare form of leukemia, caused by clonal proliferation of cytotoxic T-cells, characterized by modest lymphocytosis and cytopenias of other lineage with hepatosplenomegaly and relatively rare lymph nodal involvement. Involvement of other organs is extremely rare. It is predominantly an indolent disease and most of patients remain asymptomatic for a long period. We present a rare case of aggressive form (CD56 positive) of large granular lymphocytic leukemia with atypical presentations mimicking pleural malignancy on 18F-FDG PET/CT.
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