An increased incidence of non-Hodgkin's lymphoma has been reported in patients with inflammatory bowel disease, particularly in those receiving immunosuppressive therapy. Rare cases of Hodgkin;s lymphoma have been reported in a setting of inflammatory bowel disease. The mechanism underlying the apparent association is unclear, but alterations in immune surveillance could play a role. In this report we describe the clinicopathological features of primary gastrointestinal Hodgkin's lymphoma diagnosed in a patient with Crohn's ileocolitis who had been receiving therapy with immunomodulator and biologic therapies.