Isolated nasopharyngeal Hodgkin's disease presenting as nasal obstruction

Lymphomas are the second most frequent malignancy affecting the head and neck. Within head and neck lymphomas, Hodgkin's disease accounts for only 10-35% of all cases; 70-80% of Hodgkin's disease of the head and neck involves nodal tissue, with extranodal Hodgkin's disease being most often found in the tissues of Waldeyer's ring. Extranodal Hodgkin's disease of the head and neck that does not involve Waldeyer's ring is extremely rare. We report a case of isolated extranodal Hodgkin's disease of the nasopharynx who presented to the rhinology clinic with symptoms of nasal obstruction. This unusual site, the possible reasons for its rarity and the investigations and management are discussed with reference to the literature.