Sarıca Özgür, Kahraman A Nedim, Öztürk Enis, Teke Memik
Department of Radiology, Taksim Gaziosmanpaşa Training and Research Hospital, İstanbul, Turkey.
Department of Radiology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey.
Eur J Breast Health. 2018 Jan 1;14(1):29-34. doi: 10.5152/ejbh.2017.3416. eCollection 2018 Jan.
The purpose of this study is to present mammography and ultrasound findings of male breast lesions and to investigate the ability of diagnostic modalities in estimating the evolution of gynecomastia.
Sixty-nine male patients who admitted to Taksim and Bakirkoy Education and Research Hospitals and underwent mammography (MG) and ultrasonography (US) imaging were retrospectively evaluated. Duration of symptoms and mammographic types of gynecomastia according to Appelbaum's classifications were evaluated, besides the sonographic findings in mammographic types of gynecomastia.
The distribution of 69 cases were as follows: gynecomastia 47 (68.11%), pseudogynecomastia 6 (8.69%) primary breast carcinoma 7 (10.14%), metastatic carcinoma 1 (1.4%), epidermal inclusion cyst 2 (2.8%), abscess 2 (2.8%), lipoma 2 (2.8%), pyogenic granuloma 1 (1.4%), and granulomatous lobular mastitis 1 (1.4%). Gynecomastia patients who had symptoms less than 1 year had nodular gynecomastia (34.6%) as opposed to dendritic gynecomastia (61.5%) (p<0.01) based on mammography results according to Appelbaum's classifications. In patients having symptoms for 1 to 2 years, diffuse gynecomastia (70%) had a higher rate than the dendritic type (20%). Patients having the symptoms more than 2 years had diffuse gynecomastia (57.1%) while 42.9% had dendritic gynecomastia (p<0.001). With sonographic examination patients who had symptoms less than 1 year had higher rates of dendritic gynecomastia (92.3%) than noduler type (1.9 %). Patients having symptoms for 1 to 2 years had more dentritic gynecomastia (70%) than diffuse type (30%). Patients having symptoms more than 2 years had diffuse gynecomastia (57.1%) comparable to dendritic gynecomastia (42.9 %).
Diagnostic imaging modalities are efficient tools for estimation of gynecomastia evolution as well as the diagnosis of other male breast diseases. There seems to be an incongruity between duration of clinical complaints and diagnostic imaging classification of gynecomastia. The use of these high resolution US findings may demonstrate an early phase fibrosis especially in patients visualized by mammography as with nodular phase.
本研究旨在呈现男性乳腺病变的乳房X线摄影和超声检查结果，并探讨诊断方法评估男性乳腺增生演变的能力。
回顾性评估了69例入住塔克西姆和巴克尔科伊教育与研究医院并接受乳房X线摄影（MG）和超声检查（US）成像的男性患者。除了男性乳腺增生的乳房X线摄影类型中的超声检查结果外，还评估了症状持续时间以及根据阿佩尔鲍姆分类的男性乳腺增生的乳房X线摄影类型。
69例病例的分布如下：男性乳腺增生47例（68.11%），假性男性乳腺增生6例（8.69%），原发性乳腺癌7例（10.14%），转移性癌1例（1.4%），表皮样囊肿2例（2.8%），脓肿2例（2.8%），脂肪瘤2例（2.8%），化脓性肉芽肿1例（1.4%），肉芽肿性小叶性乳腺炎1例（1.4%）。根据阿佩尔鲍姆分类的乳房X线摄影结果，症状持续时间少于1年的男性乳腺增生患者结节性男性乳腺增生的比例为34.6%，而树枝状男性乳腺增生的比例为61.5%（p<0.01）。症状持续1至2年的患者中，弥漫性男性乳腺增生（70%）的比例高于树枝状类型（20%）。症状持续超过2年的患者中，弥漫性男性乳腺增生的比例为57.1%，而树枝状男性乳腺增生的比例为42.9%（p<0.001）。通过超声检查，症状持续时间少于1年的患者中，树枝状男性乳腺增生的比例（92.3%）高于结节型（1.9%）。症状持续1至2年的患者中，树枝状男性乳腺增生的比例（70%）高于弥漫型（30%）。症状持续超过2年的患者中，弥漫性男性乳腺增生（57.1%）与树枝状男性乳腺增生（42.9%）相当。
诊断性成像方法是评估男性乳腺增生演变以及诊断其他男性乳腺疾病的有效工具。临床症状持续时间与男性乳腺增生的诊断性成像分类之间似乎存在不一致。这些高分辨率超声检查结果的应用可能显示早期纤维化，特别是在乳房X线摄影显示为结节期的患者中。
