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Gynecomastoid Hyperplasia: Imaging Findings in Six Patients¹

¹ From the Departments of Radiology (D.L.G.S., M.H.L., J.E.M.), Pathology (S.C.L.), and Surgery (C.M.K.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115; the Department of Radiology, Milton Hospital, Mass (C.D.K.); and the Department of Pathology, University of Nebraska Medical Center, Omaha (J.A.G.). Received June 26, 1998; revision requested July 16; final revision received April 16, 1999; accepted July 28. Address reprint requests to D.L.G.S. (e-mail: dgselland@bics.bwh.harvard.edu).

View larger version (158K): [in a new window]   Figure 1a. Patient 4. Bilateral mammograms obtained in a 49-year-old nulliparous woman with primary amenorrhea and severely short stature who was receiving hormone replacement therapy and who presented with a new, palpable, retroareolar mass in the right breast. Biopsy revealed gynecomastoid hyperplasia. (a) Mediolateral oblique projections in 1996 show an asymmetric retroareolar density (arrows) in the right breast that was stable relative to the appearance on a mammogram obtained 2 years previously. (b) Craniocaudal projections from the same day as a show asymmetric retroareolar tissue (arrows) in the right breast. (c) Mediolateral oblique projections in 1997 demonstrate an enlarging asymmetric density (arrows) in the retroareolar region in the right breast that corresponds to the area of palpable concern (metallic skin BB). (d) Craniocaudal projections from the same day as c show an enlarging asymmetric density (arrows) in the retroareolar region of the right breast.

View larger version (127K): [in a new window]   Figure 1b. Patient 4. Bilateral mammograms obtained in a 49-year-old nulliparous woman with primary amenorrhea and severely short stature who was receiving hormone replacement therapy and who presented with a new, palpable, retroareolar mass in the right breast. Biopsy revealed gynecomastoid hyperplasia. (a) Mediolateral oblique projections in 1996 show an asymmetric retroareolar density (arrows) in the right breast that was stable relative to the appearance on a mammogram obtained 2 years previously. (b) Craniocaudal projections from the same day as a show asymmetric retroareolar tissue (arrows) in the right breast. (c) Mediolateral oblique projections in 1997 demonstrate an enlarging asymmetric density (arrows) in the retroareolar region in the right breast that corresponds to the area of palpable concern (metallic skin BB). (d) Craniocaudal projections from the same day as c show an enlarging asymmetric density (arrows) in the retroareolar region of the right breast.

View larger version (150K): [in a new window]   Figure 1c. Patient 4. Bilateral mammograms obtained in a 49-year-old nulliparous woman with primary amenorrhea and severely short stature who was receiving hormone replacement therapy and who presented with a new, palpable, retroareolar mass in the right breast. Biopsy revealed gynecomastoid hyperplasia. (a) Mediolateral oblique projections in 1996 show an asymmetric retroareolar density (arrows) in the right breast that was stable relative to the appearance on a mammogram obtained 2 years previously. (b) Craniocaudal projections from the same day as a show asymmetric retroareolar tissue (arrows) in the right breast. (c) Mediolateral oblique projections in 1997 demonstrate an enlarging asymmetric density (arrows) in the retroareolar region in the right breast that corresponds to the area of palpable concern (metallic skin BB). (d) Craniocaudal projections from the same day as c show an enlarging asymmetric density (arrows) in the retroareolar region of the right breast.

View larger version (123K): [in a new window]   Figure 1d. Patient 4. Bilateral mammograms obtained in a 49-year-old nulliparous woman with primary amenorrhea and severely short stature who was receiving hormone replacement therapy and who presented with a new, palpable, retroareolar mass in the right breast. Biopsy revealed gynecomastoid hyperplasia. (a) Mediolateral oblique projections in 1996 show an asymmetric retroareolar density (arrows) in the right breast that was stable relative to the appearance on a mammogram obtained 2 years previously. (b) Craniocaudal projections from the same day as a show asymmetric retroareolar tissue (arrows) in the right breast. (c) Mediolateral oblique projections in 1997 demonstrate an enlarging asymmetric density (arrows) in the retroareolar region in the right breast that corresponds to the area of palpable concern (metallic skin BB). (d) Craniocaudal projections from the same day as c show an enlarging asymmetric density (arrows) in the retroareolar region of the right breast.

View larger version (146K): [in a new window]   Figure 2a. Patient 6. Images obtained in a 54-year-old postmenopausal woman receiving hormone replacement therapy who had a prior history of regular menses, gravida 3, para 3, and a family history of breast carcinoma (mother). (a) Right craniocaudal mammogram shows a 1-cm noncalcified nodule (arrows) deep in the right breast. (b) US image obtained at the same time as a at the 6-o'clock position shows a solid hypoechoic nodule (arrowheads). (c) Photomicrograph shows gynecomastoid hyperplasia. Small ducts with papillary hyperplasia (arrows) are surrounded by cellular stroma with a mild lymphocytic infiltrate. The area of gynecomastoid change borders on an area of adjacent adipose tissue (arrowheads). (Hematoxylin-eosin stain; original magnification, x125.)

View larger version (207K): [in a new window]   Figure 2b. Patient 6. Images obtained in a 54-year-old postmenopausal woman receiving hormone replacement therapy who had a prior history of regular menses, gravida 3, para 3, and a family history of breast carcinoma (mother). (a) Right craniocaudal mammogram shows a 1-cm noncalcified nodule (arrows) deep in the right breast. (b) US image obtained at the same time as a at the 6-o'clock position shows a solid hypoechoic nodule (arrowheads). (c) Photomicrograph shows gynecomastoid hyperplasia. Small ducts with papillary hyperplasia (arrows) are surrounded by cellular stroma with a mild lymphocytic infiltrate. The area of gynecomastoid change borders on an area of adjacent adipose tissue (arrowheads). (Hematoxylin-eosin stain; original magnification, x125.)

View larger version (224K): [in a new window]   Figure 2c. Patient 6. Images obtained in a 54-year-old postmenopausal woman receiving hormone replacement therapy who had a prior history of regular menses, gravida 3, para 3, and a family history of breast carcinoma (mother). (a) Right craniocaudal mammogram shows a 1-cm noncalcified nodule (arrows) deep in the right breast. (b) US image obtained at the same time as a at the 6-o'clock position shows a solid hypoechoic nodule (arrowheads). (c) Photomicrograph shows gynecomastoid hyperplasia. Small ducts with papillary hyperplasia (arrows) are surrounded by cellular stroma with a mild lymphocytic infiltrate. The area of gynecomastoid change borders on an area of adjacent adipose tissue (arrowheads). (Hematoxylin-eosin stain; original magnification, x125.)