Lymphographic studies in acute lymphogranuloma venereum infection.

Lymphography, a radiological method of demonstrating lymphatic channels and nodes, has been used to investigate three cases of acute bubonic lymphogranuloma venereum (LGV). There is general agreement that LGV has a predilection for lymphatic channels and lymph nodes. However, very little is known of the extent of lymph node involvement in the early bubonic stage and whether there is merely a lymphangitis or complete lymphatic obstruction. The present study was undertaken to determine the lymphographic appearance in acute bubonic LGV, the extent of lymphatic node involvement in early LGV, and the usefulness of the procedure in the management of LGV patients. The buboes were not outlined by this procedure. The vessel phase of the lymphogram appeared normal, while the nodal phase showed a gradient of pathological involvement from the inguinal region lessening towards the lumbar nodes. The main drawbacks of lymphography in LGV are the difficulty of visualizing the lymphatics in the negroid skin and the lack of diagnostic criteria for inflammatory diseases of the lymphatic system. The lymphographic findings in LGV as described here may be regarded as typical of LGV but cannot be accepted as specific for LGV with a high degree of confidence. It is suggested that the procedure could be used for monitoring patients with the severe and late sequelae of LGV infection.