Imaging in Hemophagocytic Lymphohistiocytosis: A Comprehensive Pictorial Essay

Caleb Bhatnagar1, Emad Allam1, Mathew Illimoottil2

  • 1Radiology, Loyola University Medical Center, Maywood, USA.

Cureus
|September 2, 2025
PubMed

Hemophagocytic lymphohistiocytosis (HLH) is a rare but life-threatening condition characterized by excessive immune activation, resulting in severe systemic inflammation and multiorgan failure. This pictorial essay presents an overview of HLH imaging findings, accompanied by a discussion of pathophysiology, diagnosis, and treatment approaches. Imaging is crucial in diagnosing and monitoring HLH by identifying key features, such as splenomegaly, lymphadenopathy, and central nervous system (CNS) involvement. While the imaging findings associated with HLH are nonspecific and do not constitute part of the diagnostic criteria for HLH, they are helpful in the diagnostic process and can offer valuable insights into the extent of organ involvement and disease progression, guiding timely interventions. This article emphasizes the importance of recognizing imaging patterns associated with HLH for early diagnosis and effective management.

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