Classic Hodgkin's Lymphoma is a disease usually characterized by lymph nodal presentation. Rare cases with extra-nodal first clinical manifestation may occur, and primary bone marrow involvement may be part of them: isolated bone marrow forms have been recently described in the context of HIV infection. We herein report a case of isolated bone marrow Hodgkin's Lymphoma occurrence in a HIV-negative, elderly patient. The impacts of such unusual Hodgkin's Lymphoma manifestation on clinical practice as well as the related diagnostic and therapeutic implications are discussed.