A 43-year-old man was admitted to our hospital with nasal obstruction,high fever,ough,hemoptysis,hoarseness and sore throat.The superficial lymph node was not palpable,and computed tomographic scans of chest showed bilateral lungs of multiple patches and nodular high density,with both sided pleural effusion.The pleural effusion was exudative,adenosine deaminase (ADA) level was significantly elevated (316U/L).Therefore pleuritis tuberculosa was of first consider.But we finally diagnosed the case as natural killer (NK)/T-cell lymphoma from CT-guided needle biopsy.In this case,high ADA level in pleural effusion suggested lymphoma.To our konwledge,this report is an extremely rare case.