The examination of serous effusions (pleural fluid, peritoneal and pericardial) for the detection of malignancy is commonplace in routine cytology practice. It is the first line of investigation in patients presenting with body cavity effusions. Cytological detection of malignancy does not bode well in a known case of malignancy as it is associated with a poor prognosis. 1 Further, diagnosis of

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Patients with multiple endocrine neoplasia type 1 usually have a combination of endocrine disorders due to lesions in the pancreas, parathyroid gland, and pituitary gland. Functional imaging using different tracers in addition to conventional imaging are applied in localizing the primary sites, determining the disease extent, and characterizing the lesions. We present a diagnosed case of multiple endocrine neoplasia type 1 with interesting incidental imaging findings showing 99m Tc-sestamibi and 18 F-fluorocholine uptake in addition to 68 Ga-DOTANOC uptake in metastatic mediastinal and cervical lymph nodes arising from gastroenteropancreatic neuroendocrine tumor. This case shows the possibility of imaging the neuroendocrine tumors with 3 different tracers, namely 68 Ga-DOTANOC, 99m Tc-sestamibi, and 18 F-fluorocholine.

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