The authors present a retrospective single institution review of patients with a very rare variant of non-Hodgkin lymphomas (NHL). They report on the occurrence, clinical course and outcomes of their patients with natural killer / T-cell lymphoma (NKTCL) nasal type. Sixty-three patients with NHL were treated between 2006 and 2011. Of these 11 had extranodal lymphoma with six in the head and neck; of these three had NKTCL nasal type group. They report three clinical cases leading to the diagnosis and treatment course of the disease and outcomes. Two of the three had aggressive disease resistant to chemotherapy. The authors discuss a tumour rarely found in Europeans, but highlight its aggressive nature, chemo resistance and poor clinical outcomes. Because this can present with features of upper respiratory tract infection, it could be seen by a maxillofacial or otolaryngology practitioner and authors do a good job of drawing attention to this disease.