A 46-year-old male patient presented with fatigue, weight loss, anemia and dyspeptic complaints for the last 2 months. Gastric cancer was diagnosed with upper endoscopic biopsy. FDG-PET/CT was ordered in order to initial staging. PET/CT images not only demonstrated increased FDG accumulation at the primary tumor site but also revealed multiple metastatic intraabdominal lymphadenopathies and left supraclavicular lymph node. Heterogeneous widespread FDG uptake in the axial skeleton suggested bone marrow involvement (Fig. 1). Hgb was 9.5 g/dL; WBC, 4,100 and PLT, 33,000 per µL. Bone marrow biopsy showed metastatic gastric cancer.