Gynecomastia

General

• Gynecomastia simply refers to an increased amount of breast tissue in a male

• Uncommon condition.

• A minority of cases are associated with BRCA2 mutation.

Clinical picture

1. Young boy with enlarged breasts (can be unilateral).

• May be idiopathic & resolve spontaneously. Some require surgery

2. Old man with enlarged breasts

• Due to high estrogen levels:

1. Cirrhosis (decreased hepatic clearance of estrogen)

2. Some drugs

3. Klinefelter syndrome (XXY)

4. Leydig cell tumor of testis

3. Other

• Can be seen in hyperthyroidism, prolactinomas, or AIDS patients on HAART therapy

Histology

• Abundant collagenous dense stroma with only small ductular tissue with loss of lobular units

  • End ducts without lobules

  • Can have well or poorly defined borders

  • Can see ductal epithelial hyperplasia or prominent periductular edema

    • looks similar to desmoplastic stromal reaction or pseudoangiomatous stromal hyperplasia

Sign Out

Breast, [Right/Left], mammoplasty:

- Benign breast tissue, (weight) g.