Penile intracavernosal substance abuse.

A complete workup for a 36-year-old man with unexplained inguinal adenopathy and an indurated, enlarged penis and scrotum included urine cultures for bacteria, fungi, and acid-fast bacilli; scrotal ultrasound; computed tomography of the abdomen and groin; a retrograde urethrogram; a cystogram; duplex penile Doppler blood flow studies; and a surgical inguinal lymph node dissection. Pathologic examination of the excised lymph node revealed lipoid granulomatous lymphadenitis. After receiving definitive treatment for a psychotic condition, the patient acknowledged a 2-year history of intracavernosal injection of gelatinous vitamin E.