This case represents mediastinal lymphoma pathologically proved nodular sclerosing Hodgkin lymphoma, presented as a huge mediastinal soft tissue mass lesion with mediastinal lymph nodes as well as cervical and right axillary lymph nodes. No abdominal involvement. Nodular sclerosing Hodgkin lymphoma is a type of primary mediastinal lymphomas. Approximately 60% of all Hodgkin lymphoma involves the mediastinum at presentation.