Interesting ImagesProgressive Transformation of Germinal Centers Simulating Malignant Axillary Lymphadenopathy in a Breast Cancer Patient on FDG PET/CTHod, Nir MHA, MD∗; Nalbandyan, Karen MD†; Porges, Tzvika MD‡; Lantsberg, Sophie MD∗ Author Information From the ∗Institute of Nuclear Medicine and Molecular Imaging Departments of †Pathology ‡Hematology, Soroka University Medical Center (affiliated to Ben Gurion University of the Negev, Faculty of Health Sciences), Beer-Sheva, Israel. Received for publication June 6, 2022; revision accepted October 11, 2022. Conflicts of interest and sources of funding: none declared. Correspondence to: Nir Hod, MHA, MD, Institute of Nuclear Medicine and Molecular Imaging, Soroka University Medical Center, PO Box 151, Rager Blvd, Beer-Sheva 84101, Israel. E-mail: [email protected]. Clinical Nuclear Medicine 48(2):p e89-e91, February 2023. | DOI: 10.1097/RLU.0000000000004493 Buy Metrics Abstract A 64-year-old woman with breast cancer underwent FDG PET/CT for follow-up. The study revealed highly increased FDG uptake in newly diagnosed enlarged axillary lymph nodes, which were worrisome for malignancy. Histopathology revealed a rarely diagnosed benign disease of progressive transformation of germinal centers mimicking malignant lymphadenopathy. As imaging findings of this entity, which usually involves the axillary and cervical areas, have been reported in very few studies, nuclear medicine physicians should be familiar with this potential “false-positive” FDG uptake representing an interpretative pitfall, especially during evaluation of breast cancer patients. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.