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The patient noticed a right swelling in the root of the neck that progressed from 1 \u00d7 1 cm to 5 \u00d7 6 cm. We reported a Kikuchi-like acute lymphoblastic leukemia (ALL) case. Three 3 \u00d7 3 cm lymph nodes were found in the right cervical area at IIB and III levels, firm, mobile, and nontender. Petechiae and purpura on the left upper limb, wet purpura on the palate, a positive Hess test, and temperature spikes were present. 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