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Saturday, October 5, 2013
Diseases of the Male Breast : Radiologic-Pathologic Correlation
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Abstract - Diseases of the Male Breast
Male breast disease includes a variety of
benign and malignant conditions, many of which are hormonally
influenced. Gynecomastia
and skin lesions account for the majority of
conditions in symptomatic men with a palpable abnormality, and these
conditions
should be accurately recognized. Imaging patterns
of gynecomastia include nodular, dendritic, and diffuse patterns.
Histopathologically,
the nodular and dendritic patterns correlate with
the florid and quiescent (fibrotic) phases of gynecomastia,
respectively.
The diffuse pattern may have features of both
phases and is associated with exposure to exogenous estrogen.
Benign-appearing
palpable masses in male patients should be
approached cautiously, given the overlapping morphologic features of
benign and
malignant tumors. In addition to gynecomastia,
other benign male breast tumors include lipoma, pseudoangiomatous
stromal hyperplasia,
granular cell tumor, fibromatosis,
myofibroblastoma, schwannoma, and hemangioma. Male breast cancer
accounts for 1% of all
breast carcinomas. Invasive ductal carcinoma
accounts for the majority of cases in adult males and typically appears
as a
subareolar mass without calcifications that is
eccentric to the nipple. Other epithelial and mesenchymal tumors that
may occur,
albeit not as commonly as in women, include
papillary carcinoma, invasive lobular carcinoma, adenoid cystic
carcinoma, liposarcoma,
dermatofibrosarcoma, pleomorphic hyalinizing
angiectatic tumor, basal cell carcinoma of the nipple, hematopoietic
malignancies,
and secondary tumors. Knowledge of the natural
history, clinical characteristics, and imaging features of tumors that
occur
in the male breast will help narrow the radiologic
differential diagnosis and optimize treatment.
Footnotes
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↵1 Supported by the American Institute for Radiologic Pathology (AIRP), the Joint Pathology Center (JPC), and Uniformed Services University of the Health Sciences (USU).
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Recipient of a Magna Cum Laude award for an education exhibit at the 2011 RSNA Annual Meeting.
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For this journal-based SA-CME activity, the authors, editor, and reviewers have no relevant relationships to disclose.
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The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as representing the views of the Departments of the Army, Navy, Air Force, or Defense.
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- Abbreviations:
- ACC =
- adenoid cystic carcinoma
- BCC =
- basal cell carcinoma
- GCT =
- granular cell tumor
- H-E =
- hematoxylin-eosin
- IDC =
- invasive ductal carcinoma
- ILC =
- invasive lobular carcinomar
- MLO =
- mediolateral oblique
- NOS =
- not otherwise specified
- PASH =
- pseudoangiomatous stromal hyperplasia
- PHAT =
- pleomorphic hyalinizing angiectatic tumor

This post was written by: Franklin Manuel
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