Haemospermia is usually not associated with serious disease and is, therefore, frequently considered to be a symptom of limited significance. We present a case of Hodgkin's lymphoma in which haemospermia was one of the dominant presenting symptoms .Case Report S.A., a 29-year-old male, presented with a 4-month history of haemospermia which was recently associated with a vague lower abdominal ache and erectile failure. He also reported an 18-month history of night sweats and gradual weight loss. Physical examination was normal. Routine haematological assessment revealed an elevated ESR of 107 mmjs and a low haemoglobin of 10.3 8%. Coagulation studies were normal. Intravenous urography showed medial displacement of the left ureter and left wall of the bladder (Fig.). Ultrasonography and CT scan demonstrated that this was due to left iliac lymphadenopathy and that the para-aortic and peri-pancreatic nodes were similarly enlarged. There was no evidence of supradiaphragmatic involvement. Biopsy of a left iliac lymph node showed Hodgkin's lymphoma of mixed cellularity ; chemotherapy was commenced, with an early favourable response that included complete resolution of the haemospermia.

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