A 61-year-old man with Hodgkin lymphoma (mixed type), with lymph node manifestations and extranodal and bone marrow involvement in both supra- and infradiaphragmatic locations (stage 4), had dyspnea and tachycardia on echocardiography. There were pleural and pericardial effusions and thickening of the epicardium and pericardium. These findings and computed tomographic findings were suspicious for manifestations of Hodgkin lymphoma. The pericardial findings were demonstrated on F-18 fluorodeoxyglucose positron emission tomographic imaging.