Nasal angiocentric lymphoma: An entity that should be remembered

After four nasal aesthetic functional surgeries in a period of 18 months, a 46-year-old woman was evaluated who presented with moderate functional alt eration, saddle-nose deformity, and total loss of the septal cartilage. Fou r months before presentation the patient sustained severe nasal trauma, res ulting in depression of the nasal bridge without loss of function. Her prob lem was diagnosed initially as a consequence of an infected septal hematoma and loss of the septal cartilage. Based on this diagnosis, the patient was subjected, in an 18-month period, to four reconstructive surgeries by diff erent specialists, without any improvement and with worsening of clinical p resentation. During the authors' physical examination of the patient, she d emonstrated marked nasal cutaneous retraction, atrophic nasal conchae with total loss of the septal cartilage, and a large loss of septal bone. Three nasal mucosa biopsies were acquired and the authors proceeded to carry out complete nasal reconstruction using external cranial table and rib cartilag e. Histopathologically, a lesion was noted that was compatible with angioce ntric lymphoma, for which treatment was administered according to this type of illness. The authors point out the importance of establishing an adequa te diagnosis in the face of an apparently obvious clinical case, present cr oss-disciplinary treatment, and discuss the study protocol that should be u sed for this type of pathology. They present their reconstructive technique of the nasal structure using a combination of bone tissue and cartilage, t he results, and the current state of the patient.