Persistent Nasal Cellulitis Revealing Extranodal Natural Killer/T-cell Lymphoma

Extranodal natural killer/T-cell lymphoma, nasal type (ENKTCL-NT) is a rare and aggressive non-Hodgkin lymphoma. We present a case of ENKTCL-NT in a previously healthy 37-year-old man who initially presented with persistent nasal cellulitis unresponsive to antibiotics. Despite incision and drainage plus antibiotic treatment of presumed infection, his condition worsened. After disease progression, nasal biopsy revealed angioinvasive, Epstein–Barr virus–associated ENKTCL-NT 1 month after initial presentation. This case underscores the importance of maintaining a broad differential diagnosis for refractory sinonasal symptoms, particularly among internists evaluating Latin American patients, and highlights the critical role of early biopsy in identifying this aggressive malignancy.