Photopenic metastatic lesions on bone scintigraphy have been previously reported. However, this finding is not emphasized for B-cell immunoblastic sarcoma. We report a case of B-cell immunoblastic sarcoma, which presented as an aggressive pancoast tumor with extensive rib destruction. Bone scintigraphy findings demonstrated a photopenic lesion with high gallium avidity. Correlative chest radiograph and CT scan are described.