title: Hemophagocytic lymphohistiocytosis preceded by Kikuchi disease in children.
abstract: BACKGROUND
  Kikuchi disease (KD) is a type of benign, self-limiting lymphadenitis, but it has also been associated with hemophagocytic lymphohistiocytosis (HLH). To date, only a few reports have suggested an association between HLH and KD.
  
  
  OBJECTIVE
  To report the imaging findings and clinical characteristics of KD accompanied by HLH in children.
  
  
  METHODS
  Five children with a prolonged fever and cervical lymphadenopathy were diagnosed as having HLH accompanied by KD. The authors retrospectively analyzed the clinical characteristics and the imaging findings in these children. The histology of excision biopsy samples of cervical lymph nodes in all children confirmed the diagnosis of KD. HLH was confirmed by bone marrow biopsy and laboratory criteria provided by the Histiocyte Society.
  
  
  RESULTS
  The greatest dimension of the enlarged nodes ranged from 0.5 cm to 2.5 cm and the nodes were most frequently located at level V. CT scans visualized perinodal infiltrates in most of the affected cervical nodes (four of five children) and extracervical nodes (three of three children). On enhanced CT scans, nonenhancing necrosis within the affected cervical nodes was noted in three children.
  
  
  CONCLUSIONS
  KD might be related to HLH in children. Systemic evaluations and follow-up of children with KD might help to identify HLH related to KD.
authors.affiliation: Department of Radiology, St. Mary's Hospital, The Catholic University of Korea, Seoul, 150-713, Korea. shlgy@catholic.ac.kr
authors.forename: Gye-Yeon
authors.initials: GY
authors.lastname: Lim
authors.forename: Bin
authors.initials: B
authors.lastname: Cho
authors.forename: Nak Gyun
authors.initials: NG
authors.lastname: Chung
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D020042:Histiocytic Necrotizing Lymphadenitis / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D003287:Contrast Media