We describe a case of simultaneous nodular sclerosing Hodgkin's disease and a granulocytic sarcoma in a cervical lymph node without any previous therapy. The condition evolved into acute myelogenous leukemia approximately 8 months after the initial diagnosis of the granulocytic sarcoma. The unexpected presence of a granulocytic sarcoma made the diagnosis challenging, and appropriate immunohistochemical studies were required for accurate diagnosis. To the best our knowledge, this is the first report of synchronous Hodgkin's disease and granulocytic sarcoma with eventual development of acute myelogenous leukemia.