•Primary nasal lymphoma is mainly non-Hodgkin lymphoma; NK/T-cell lymphoma is the most common type. •Nasal non-Hodgkin’s lymphoma mainly occurs in middle-aged and older men. •Clinical symptoms of patients with nasal NK/T-cell lymphoma are unspecific and the early symptoms are atypical. The main signs, changes in nasal microbiota, nasal mucosa, and surrounding organs, are easily misdiagnosed as sinusitis and nasal polyps, complicating patient awareness at the early stage. •Nasal NK/T-cell lymphoma is rare and clinically highly aggressive with a high recurrence rate and poor prognosis. Therefore, early detection and diagnosis are crucial. •Clinicopathological manifestations of nasal non-Hodgkin lymphoma are complex, and the final pathological classification needs to be confirmed using pathology and immunohistochemistry.