Lymphoma involving the ethmoid, frontal, sphenoid or maxillary sinuses is usually one of the aggressive histologic subtypes. Treatment should be given as appropriate for the histology and stage of the tumour and age of the patient. While previously it was recommended that patients with paranasal sinus lymphoma receive prophylactic intrathecal therapy, since the introduction of rituximab the risk of central nervous system involvement has significantly diminished. Therefore, the use of intrathecal prophylaxis is no longer necessary