Use of MRI to identify enlarged inferior gluteal and ischioanal lymph nodes and associated findings related to the primary disease.

Abstract

We aimed to draw attention to the lymph nodes at the inferior gluteal and ischioanal regions and evaluate the lesions accompanying them using 3.0 T magnetic resonance imaging (MRI). In total, 22 patients (15 men, 7 women; mean age, 50±11.2 years; age range, 32-71 years) were included in this study. The patients' medical records were reviewed. MRI data were reviewed on a picture archiving and communication system workstation by two radiologists in consensus. Lymph node location, laterality, number, and size were documented. The primary disorders causing the enlargement of inferior gluteal lymph nodes (n=16) were perianal fistula of cryptoglandular origin (n=5), perianal fistula associated with Crohn's disease (n=2), decubitus ulcers (n=2), presacral abscess (n=1), non-Hodgkin lymphoma (n=2), prostate cancer invading urethra and anorectal junction (n=1), endometrium cancer invading the urethra and vagina (n=1), and anal cancer (n=2). The pathologies causing the enlargement of ischioanal lymph nodes (n=6) were perianal fistula of cryptoglandular origin (n=4), subcutaneous inflammation of gluteal region related to Crohn's disease (n=1), and prostate cancer (n=1). The infectious and neoplastic lesions involving the anal canal, distal rectum, gluteal region, prostate, and urethra are the possible causes of inferior gluteal and ischioanal lymph node enlargement. Lymphoproliferative diseases can also affect these node groups. MRI is an important method to identify enlarged inferior gluteal and ischioanal lymph nodes and define associated findings.