LYMPHOGRANULOMA VENEREUM:  REPORT OF AN UNUSUAL EXAMPLE INVOLVING THE LYMPHATIC GLANDS OF THE BUTTOCK AND ADJACENT REGIONS

Clinical aspects of lymphogranuloma venereum are well known, including the extensive fistulous process which involves the female perineum, frequently associated with rectal stricture (esthiomene). The counterpart of this is seldom seen in men. The reason the rectum is more frequently spared in men is readily explained by the difference in lymph drainage; why involvement of lymphatic glands other than those of the inguinal region occurs, unless the primary lesion is extragenital,¹ is less clearly understood. Cole² has pointed out that lymphogranuloma venereum "is a disease of the lymph channels and of the nodes." The inguinal nodes receive lymph channels not only from the membranous urethra, penis and scrotum but also from the area over the fascia lata and from the gluteal region. In view of this it is surprising that most infections in the male are more or less confined to the inguinal region and do not spread