Abstract Lymphoma is one of the malignant diseases which often remain misdiagnosed due to its variable presentations. Most of them present as asymptomatic soft lesions; sometimes as primary extra-nodal disease or as disseminated disease with multiple regional lymphadenopathy. Fortunately, the slow growing type lymphomas often respond completely with advanced treatment modalities. Relapses rarely occur. But the diagnosis is often missed and mistreated due to a wide range of lymphoma mimics. We present a case of mediastinal B cell lymphoma who initially was treated as tubercular pericardial effusion on the basis of pericardial fluid study. After extensive investigations including immunohistochemistry, the diagnosis was eventually confirmed. Keywords: Mediastinal mass, Lymphadenopathy, Immunohistochemistry, Primary Mediastinal B-Cell Lymphoma (PMBCL), Diffuse Large B-Cell Lymphoma (DLBCL), Lymphoma mimic.

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