A 73-year-old man presented to the emergency department for 2 months of erythema, warmth, and blushing on the tip of the nose, with progression to ulcerative and granulomatous tissue and posterior necrotizing compromise of the nasal septum, despite antibiotic schemes. A diagnosis of lethal midline granuloma was made, a disease with a wide spectrum of etiological diagnostic possibilities and usually a poor prognosis. A biopsy sample confirms a NK/T-cell lymphoma. The patient did not accept the proposed chemotherapeutic treatment. He requested voluntary discharge and later died.