Diffuse large B-cell lymphoma (DLBCL) is an aggressive form of lymphoma with good survival if treated promptly and under appropriate management modalities. The extranodal occurrence of DLBCL in the head and neck region is uncommon in children. Diagnosis is often delayed when the presentation is atypical, especially involving unusual sites. This is a report of a 13-year-old child who presented with a headache. He had a history of infectious mononucleosis 1 year ago, diagnosed by fine-needle aspiration cytology of the cervical lymph node. Imaging studies showed a lesion in the nasopharynx extending to the parapharyngeal space. Diagnostic nasal endoscopy showed a smooth mass in the left nasal cavity, which was biopsied and diagnosed as DLBCL on histopathology and immunohistochemistry. He was treated with chemotherapy; however, the disease did not respond to the treatment. We emphasize that headaches in a young boy necessitating frequent visits to medical practitioners should not be ignored but evaluated thoroughly.
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