Gynecomastia

Dr. Naila Awal

Definition

• Enlargement of male breast

due to

hypertrophy & hyperplasia of

both

glandular & stromal component.

Pathogenesis

Estrogen

Activity (stimulate

breast tissue)

Androgen

activity

(counteracts that effect)

Fig- Imbalance b/w estrogen & androgen

Cause

• <25years of age- Hormonal pubertal change .

( During puberty, testosterone level varies. When testosterone levels are very low, higher levels of estrogen will affect the breast tissue, causing the breasts to grow larger )

• Later age-Testicular tumor-Leydig cell tumor, Sertoli cell tumor

hCG secreting germ cell tumor

Lung carcinoma

Drugs- Alcohol Marijuana Heroine

Anabolic steroid

Hormonal- Klinefelter syndrome

Idiopathic

Morphology

Site- Usualy unilateral (Idiopathic & Drug medication)

Bilateral –Pubertal & hormonal induced.

Gross-

Button like subareolar mass. (Carcinoma- ecentricaly)

Oval, Disc shaped, well circumscribed.

M/E-

Micropapillary epithelial hyperplasia of duct

Dense collagenous connective tissue

Long duration- Prominent stromal fibrosis.

Gynecomastia

Outcome

• In rare case,If intraductal epithelial hyperplasia is too extreme

Stimulate carcinoma