Hodgkin lymphoma is a type of lymphoma that occurs due to mutations in B cells of the lymphatic system. Cases of lymphoma often have identical clinical manifestations with tuberculosis (TB), making the diagnosis difficult. Case of lymphoma coincidence with TB is rare, but can probably cause complexity in the diagnosis and treatment of patients. We report the case of a 20-year-old male patient who presented with symptoms of prolonged fever, enlarged lymph nodes, loss of weight, and weakness. The patient was treated with antituberculosis medication, but the symptoms did not improve. Several investigations were carried out on the patient. Lymph node biopsy showed scattered tumor cells consisting of mononuclear Hodgkin cells with several Reed–Sternberg cells. On the other hand, the bone marrow aspiration examination was positive for Mycobacterium tuberculosis. Reconsideration of confirmed diagnosis and repeated diagnostic process are required when there is a discrepancy in clinical features, radiological findings, or treatment responses.