Diabetic gynecomastia: ultrasound criteria
AbstractAim: to analyze ultrasound features of gynecomastia in diabetic males. Methods: We analyzed the protocols of complex ultrasound examinations of 480 men of 24–74 years of age, who had gynecomastia and suffered diabetes for more than 3 years. We used S2000 (Siemens-Acuson, Germany), scanners with linear 7,5–15 MHz probes.
Results: Nodular gynecomastia was detected in 67 patients (14,0%). Ultrasound revealed a lesion of 1,2–3,8cm, predominantly of irregular shape (74,6%), heterogeneous hypoechoic structure (anechoic component was observed in 59,7% of cases), with indistinct, rough margins, and decreased vascularity with CDI and PDI (68,4%) in subareolar area. Dendritic pattern was observed in 155 patients (32,3%). It exhibited wide dense fibrous extensions of heterogeneous echostructure (anechoic component was registered in 11,5%), avascular with CDI and PDI within the breast (most often in subareolar areas). Diffuse glandular pattern was registered in 258 patients (53,7%) and presented with diffuse changes of the breast without solid lesions and cystic component. Compression elastography (in 67 patients) in all types of gynecomastia exhibited large- or medium-grained color pattern, which was irregular and practically identical to surrounding parenchyma of the gland. The average share-wave velocity (2,4m/s) with Virtual Touch Tissue Quantification (ARFI) and the average strain-ratio (1,1–1,2) did not show any statistically significant difference from the same in normal tissues of the organ.
Conclusions: The sensitivity of modern ultrasound examination in diagnosis of gynecomastia in males with diabetes was 86.0% with specificity of 82,1%.
Keywords:ingibitors of dipeptidylpeptidazy type 4, metformin, type 2 diabetes mellitus, obesity