Sinonasal natural killer/T-cell lymphoma presenting as pyrexia of unknown origin with nasal symptoms

Natural Killer (NK)//T-Cell Lymphoma, Nasal Type, with Periorbital Involvement: A Case Report and Literature Review

Patient: Female, 36-year-old

Final Diagnosis: NK/T-cell lymphoma

Symptoms: Nasal congestion • rhinorrea • sinus congestion

Medication: —

Clinical Procedure: —

Specialty: Otolaryngology

Deceptive nasal NK/T-cell lymphoma

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.