Abstract：
BACKGROUND: The main etiology of acute pancreatitis includes biliary origin and alcohol, although various other causes include drugs (i.e., L-asparaginase) or malignant tumors. Since accurate identification of etiologies is crucial for determining therapeutic planning, the assessment of cause should be performed as early as possible.
METHODS: A 57-year-old Korean man was admitted for chemotherapy. The patient did not drink alcohol for religious reason. 26 days prior to admission, a 4 cm-sized testicular mass was observed in ultrasound and he received right radial orchiectomy. Extranodal natural killer/T-cell lymphoma, nasal type, was diagnosed. After confirming no additional abnormal findings, chemotherapy (using the regimens Dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide) was begun. On Day 8 of chemotherapy, L-asparaginase was started and he complained of sudden onset epigastric pain after 2 days. Acute pancreatitis was diagnosed and, in order to determine if the acute pancreatitis occurred due to L-asparaginase or pancreas involvement of extranodal natural killer/T-cell lymphoma, endoscopic ultrasonography guided fine needle biopsy was performed and observed diffusely infiltrated tumor cells. Therefore, he was given a final diagnosis of acute pancreatitis due to pancreas involvement of extranodal natural killer/T-cell lymphoma, nasal type.
CONCLUSIONS: Acute pancreatitis caused by pancreas involvement of extranodal natural killer/T-cell lymphoma, nasal type, is a very rare disease but can occur during chemotherapy. To identify the cause of acute pancreatitis, endoscopic ultrasonography guided fine needle biopsy can be considered.
METHODS: A 57-year-old Korean man was admitted for chemotherapy. The patient did not drink alcohol for religious reason. 26 days prior to admission, a 4 cm-sized testicular mass was observed in ultrasound and he received right radial orchiectomy. Extranodal natural killer/T-cell lymphoma, nasal type, was diagnosed. After confirming no additional abnormal findings, chemotherapy (using the regimens Dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide) was begun. On Day 8 of chemotherapy, L-asparaginase was started and he complained of sudden onset epigastric pain after 2 days. Acute pancreatitis was diagnosed and, in order to determine if the acute pancreatitis occurred due to L-asparaginase or pancreas involvement of extranodal natural killer/T-cell lymphoma, endoscopic ultrasonography guided fine needle biopsy was performed and observed diffusely infiltrated tumor cells. Therefore, he was given a final diagnosis of acute pancreatitis due to pancreas involvement of extranodal natural killer/T-cell lymphoma, nasal type.
CONCLUSIONS: Acute pancreatitis caused by pancreas involvement of extranodal natural killer/T-cell lymphoma, nasal type, is a very rare disease but can occur during chemotherapy. To identify the cause of acute pancreatitis, endoscopic ultrasonography guided fine needle biopsy can be considered.
摘要：
背景：急性胰腺炎的主要病因包括胆源性和酒精，尽管各种其他原因包括药物(即，L-天冬酰胺酶）或恶性肿瘤。由于病因的准确识别对于确定治疗计划至关重要，应尽早进行病因评估。
方法：一名57岁的韩国男子入院接受化疗。患者因宗教原因不饮酒。入院前26天，在超声检查中观察到4cm大小的睾丸肿块，他接受了右放射状睾丸切除术。结外自然杀伤/T细胞淋巴瘤，鼻型,被诊断出来了.确认没有其他异常发现后，化疗(使用地塞米松方案，甲氨蝶呤,异环磷酰胺,L-天冬酰胺酶,和依托泊苷）开始。在化疗的第8天，开始使用L-天冬酰胺酶，2天后他抱怨突然发作的上腹痛。诊断为急性胰腺炎，为了确定急性胰腺炎是否由于L-天冬酰胺酶或结外自然杀伤/T细胞淋巴瘤的胰腺受累而发生，超声内镜引导下进行细针活检，观察弥漫性浸润的肿瘤细胞。因此,由于结外自然杀伤/T细胞淋巴瘤的胰腺受累，他最终被诊断为急性胰腺炎，鼻型。
结论：结外自然杀伤/T细胞淋巴瘤胰腺受累引起的急性胰腺炎，鼻型,是一种非常罕见的疾病，但可以在化疗期间发生。为了确定急性胰腺炎的病因,超声内镜引导下细针活检可以考虑。
方法：一名57岁的韩国男子入院接受化疗。患者因宗教原因不饮酒。入院前26天，在超声检查中观察到4cm大小的睾丸肿块，他接受了右放射状睾丸切除术。结外自然杀伤/T细胞淋巴瘤，鼻型,被诊断出来了.确认没有其他异常发现后，化疗(使用地塞米松方案，甲氨蝶呤,异环磷酰胺,L-天冬酰胺酶,和依托泊苷）开始。在化疗的第8天，开始使用L-天冬酰胺酶，2天后他抱怨突然发作的上腹痛。诊断为急性胰腺炎，为了确定急性胰腺炎是否由于L-天冬酰胺酶或结外自然杀伤/T细胞淋巴瘤的胰腺受累而发生，超声内镜引导下进行细针活检，观察弥漫性浸润的肿瘤细胞。因此,由于结外自然杀伤/T细胞淋巴瘤的胰腺受累，他最终被诊断为急性胰腺炎，鼻型。
结论：结外自然杀伤/T细胞淋巴瘤胰腺受累引起的急性胰腺炎，鼻型,是一种非常罕见的疾病，但可以在化疗期间发生。为了确定急性胰腺炎的病因,超声内镜引导下细针活检可以考虑。
