Delayed Diagnosis of Nasal NK/T-Cell Lymphoma Following Rhinoplasty: A Cautionary Case Report

Background: Extranodal NK/T-cell lymphoma, nasal type (ENKTCL-NT) often presents with non-specific symptoms that mimic benign sinonasal conditions, leading to diagnostic delays. This challenge is amplified in post-operative patients, where symptoms can be attributed to surgical sequelae. Case Presentation: A 43-year-old male presented with persistent nasal obstruction and discharge three months after undergoing rhinoplasty. Initial evaluation suggested post-operative inflammation. However, subsequent imaging revealed a destructive soft tissue mass with extensive bone erosion. Endoscopic biopsy and immunohistochemical analysis (positive for CD3, CD56, CD30) confirmed a diagnosis of high-grade ENKTCL-NT. Conclusion: The patient achieved complete remission after definitive chemoradiotherapy. This case underscores that ENKTCL-NT can masquerade as routine post-surgical inflammation. Clinicians must maintain a high index of suspicion for malignancy in patients with refractory or progressive sinonasal symptoms following surgery to ensure timely diagnosis and treatment.