Gynecomastia

Case contributed by Dr Daniel J Bell

Presentation

Breathlessness and cough, is there pneumonia present?

Patient Data

Age: 35 years
Gender: Male

PA chest

X-ray

Lungs and pleural spaces clear. Heart is not enlarged.

Incidental note of symmetric gynecomastia.

Case Discussion

The importance of a case like this is to appreciate how a male patient with gynecomastia can really be indistinguishable from a young female patient with normal breasts. Most cases of gynecomastia have a much more asymmetric or even completely unilateral appearance.

During a busy reading session it is easy to be careless and mistake such a chest radiograph for a female patient.

The term pseudogynecomastia is occasionally used for male patients who appear to have breast enlargement in which it is primarily due to fatty tissue and not true glandular or stromal mammary tissue. This cannot be diagnosed on chest radiography, requiring mammography and/or ultrasound.

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