Nasal NK/T cell lymphoma is rare and it easily masquerades as chronic rhinosinusitis. It has a very poor prognosis and hence early diagnosis, although difficult, is necessary for better outcome. We present a case of a 30-year-old man who presented with nasal obstruction, facial oedema and crusts. High-resolution computed tomography found soft tissue in all sinuses and the nasal cavity. Endoscopic biopsy revealed necrotic and inflammatory tissue with fungi on culture. A diagnosis of fungal rhinosinusitis was made but the patient did not respond to antifungal drugs. A histopathology review with immunohistochemistry suggested nasal NK/T cell lymphoma. The patient was started on chemotherapy but died within 1 week.
Keywords: Diagnosis; Extranodal NK-T-cell Lymphoma; Fungal pathology; Lethal midline granuloma; Nose; Sinusitis.