{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T20:27:22Z","timestamp":1776371242531,"version":"3.51.2"},"reference-count":11,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T00:00:00Z","timestamp":1692576000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Indian J Radiol Imaging"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hemophagocytic lymphohistiocytosis (HLH) is an uncommon condition, which can result either from a primary genetic abnormality affecting children or secondary to various conditions like malignancy or infection predominantly in adults. HLH is associated with immune dysregulation, resulting in an uncontrolled overproduction and infiltration of lymphocytes and histiocytes. The infiltration predominantly involves liver, spleen, lymph nodes, and central nervous system. Neuroimaging features on magnetic resonance imaging are highly nonspecific and variable. The most typical findings include periventricular white matter hyperintensities and diffuse atrophy. Ring or nodular enhancing or nonenhancing focal parenchymal lesions may be seen. Here, we present three pediatric cases of primary HLH with a wide spectrum of imaging findings involving cerebral and cerebellar cortex, white matter, deep gray matter, and brain stem. The findings in these patients range from small nonenhancing hemorrhagic lesions and enhancing small lesions to ill-defined mass with mass effect and midline shift. Lesions in deep gray matter including thalamus, basal ganglia, and also brain stem in HLH are rarely described in literature. Early diagnosis of HLH and timely management can improve the course of the disease.<\/jats:p>","DOI":"10.1055\/s-0043-1772495","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T23:08:15Z","timestamp":1692659295000},"page":"548-554","source":"Crossref","is-referenced-by-count":8,"title":["Imaging Spectrum of Neurological Manifestations of Hemophagocytic Lymphohistiocytosis in Pediatrics: A Case Series"],"prefix":"10.1055","volume":"33","author":[{"given":"Geethapriya","family":"Sivaramalingam","sequence":"additional","affiliation":[{"name":"Department of Radiology, Apollo Speciality Hospital, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0666-5375","authenticated-orcid":false,"given":"Afiya","family":"VK","sequence":"additional","affiliation":[{"name":"Department of Radiology, Apollo Speciality Hospital, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9338-372X","authenticated-orcid":false,"given":"Bagyam","family":"Raghavan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Apollo Speciality Hospital, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3067-3316","authenticated-orcid":false,"given":"Jayaraj","family":"Govindaraj","sequence":"additional","affiliation":[{"name":"Department of Radiology, Apollo Speciality Hospital, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,8,21]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/S0022-3476(97)70196-3","article-title":"Neuropathologic findings and neurologic symptoms in twenty-three children with hemophagocytic 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Kollias","year":"1994","journal-title":"Radiology"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1111\/j.1365-2141.2007.06922.x","article-title":"Frequency and spectrum of central nervous system involvement in 193 children with haemophagocytic lymphohistiocytosis","volume":"140","author":"A Horne","year":"2008","journal-title":"Br J Haematol"},{"issue":"15","key":"ref6","doi-asserted-by":"crossref","first-page":"4041","DOI":"10.1182\/blood-2011-03-278127","article-title":"How I treat hemophagocytic lymphohistiocytosis","volume":"118","author":"M B Jordan","year":"2011","journal-title":"Blood"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1007\/s00247-003-0894-9","article-title":"Imaging characteristics of hemophagocytic lymphohistiocytosis","volume":"33","author":"N E Fitzgerald","year":"2003","journal-title":"Pediatr Radiol"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1007\/s10072-010-0467-2","article-title":"Hemophagocytic lymphohistiocytosis with neurological presentation: MRI findings and a nearly miss diagnosis","volume":"32","author":"L Chiapparini","year":"2011","journal-title":"Neurol Sci"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.jns.2015.07.017","article-title":"Neurological involvement and characterization in acquired hemophagocytic lymphohistiocytosis in adulthood","volume":"357","author":"S M Gratton","year":"2015","journal-title":"J Neurol Sci"},{"issue":"12","key":"ref10","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1007\/s00234-020-02511-y","article-title":"Bilateral lesions of the basal ganglia and thalami (central grey matter)-pictorial review","volume":"62","author":"S Van 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