Gynecomastia pathophysiology

Revision as of 14:51, 15 November 2017 by Mmir (talk | contribs) (→‎Genetics)
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)
Jump to navigation Jump to search

Gynecomastia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Gynecomastia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic study of choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Gynecomastia pathophysiology On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Gynecomastia pathophysiology

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Gynecomastia pathophysiology

CDC on Gynecomastia pathophysiology

Gynecomastia pathophysiology in the news

Blogs on Gynecomastia pathophysiology

Directions to Hospitals Treating Gynecomastia

Risk calculators and risk factors for Gynecomastia pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Husnain Shaukat, M.D [2]

Overview

The main pathophysiology behind gynecomastia is increased estrogen to androgen ratio which can occur through multiple mechanisms. These mechanisms can be physiological, pathological or pharmacological.

Pathophysiology

Hormones involved in breast development


 
 
 
 
 
 
 
 
 
 
Breast Tissue
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Stimulatory Action
 
 
 
 
 
 
 
 
 
 
 
 
 
Inhibitory Action
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Estrogen
 
 
 
 
 
 
 
 
 
 
 
 
 
Androgens
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
GH & IGF-1
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Pathogenesis

Some examples regarding gynecomastia development based on the pathophysiology include:

Conditions causing increased estrogen Conditions causing decreased testosterone

Genetics

Genes involved in the pathogenesis of aromatase overexpression form of gynecomastia is encoded by a chromosome 15q21.2.[8] As a result, any mutation in the mentioned loci result in aromatase overexpression.

Associated Conditions

Gynecomastia is associated with psychological stress such as:[11][12][13][14]

Gross Pathology

On gross pathology, characteristic findings of gynecomastia include:

Microscopic Pathology

On microscopic inspection, gynecomastia histology shows:[15]

Ductal hyperplasia, source:https://librepathology.org


Gynecomastoid hyperplasia, source:https://librepathology.org


References

  1. Bocchinfuso WP, Korach KS (1997). "Mammary gland development and tumorigenesis in estrogen receptor knockout mice". J Mammary Gland Biol Neoplasia. 2 (4): 323–34. PMID 10935020.
  2. Lubahn DB, Moyer JS, Golding TS, Couse JF, Korach KS, Smithies O (1993). "Alteration of reproductive function but not prenatal sexual development after insertional disruption of the mouse estrogen receptor gene". Proc. Natl. Acad. Sci. U.S.A. 90 (23): 11162–6. PMC 47942. PMID 8248223.
  3. Kleinberg DL, Feldman M, Ruan W (2000). "IGF-I: an essential factor in terminal end bud formation and ductal morphogenesis". J Mammary Gland Biol Neoplasia. 5 (1): 7–17. PMID 10791764.
  4. Mieritz MG, Sorensen K, Aksglaede L, Mouritsen A, Hagen CP, Hilsted L, Andersson AM, Juul A (2014). "Elevated serum IGF-I, but unaltered sex steroid levels, in healthy boys with pubertal gynaecomastia". Clin. Endocrinol. (Oxf). 80 (5): 691–8. doi:10.1111/cen.12323. PMID 24033660.
  5. 5.0 5.1 5.2 De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, Koch C, Korbonits M, McLachlan R, New M, Purnell J, Rebar R, Singer F, Vinik A, Swerdloff RS, Ng J. PMID 25905330. Vancouver style error: initials (help); Missing or empty |title= (help)
  6. Barros AC, Sampaio Mde C (2012). "Gynecomastia: physiopathology, evaluation and treatment". Sao Paulo Med J. 130 (3): 187–97. PMID 22790552.
  7. Li X, Wärri A, Mäkelä S, Ahonen T, Streng T, Santti R; et al. (2002). "Mammary gland development in transgenic male mice expressing human P450 aromatase". Endocrinology. 143 (10): 4074–83. doi:10.1210/en.2002-220181. PMID 12239119.
  8. 8.0 8.1 Shozu M, Sebastian S, Takayama K, Hsu WT, Schultz RA, Neely K; et al. (2003). "Estrogen excess associated with novel gain-of-function mutations affecting the aromatase gene". N Engl J Med. 348 (19): 1855–65. doi:10.1056/NEJMoa021559. PMID 12736278.
  9. Johnson RE, Murad MH (2009). "Gynecomastia: pathophysiology, evaluation, and management". Mayo Clin Proc. 84 (11): 1010–5. doi:10.1016/S0025-6196(11)60671-X. PMC 2770912. PMID 19880691.
  10. Mathur R, Braunstein GD (1997). "Gynecomastia: pathomechanisms and treatment strategies". Horm Res. 48 (3): 95–102. PMID 11546925.
  11. Wassersug, Richard J.; Oliffe, John L. (2009). "The Social Context for Psychological Distress from Iatrogenic Gynecomastia with Suggestions for Its Management". The Journal of Sexual Medicine. 6 (4): 989–1000. doi:10.1111/j.1743-6109.2008.01053.x. ISSN 1743-6095.
  12. Strømsvik, Nina; Råheim, Målfrid; Øyen, Nina; Engebretsen, Lars Fredrik; Gjengedal, Eva (2010). "Stigmatization and Male Identity: Norwegian Males' Experience after Identification as BRCA1/2 Mutation Carriers". Journal of Genetic Counseling. 19 (4): 360–370. doi:10.1007/s10897-010-9293-1. ISSN 1059-7700.
  13. Hack, Thomas F.; Sawatzky, Jo-Ann; Pedersen, Allison E. (2010). "The Sequelae of Anxiety in Breast Cancer: A Human Response to Illness Model". Oncology Nursing Forum. 37 (4): 469–475. doi:10.1188/10.ONF.469-475. ISSN 0190-535X.
  14. Senín-Calderón, Cristina; Rodríguez-Testal, Juan F.; Perona-Garcelán, Salvador; Perpiñá, Conxa (2017). "Body image and adolescence: A behavioral impairment model". Psychiatry Research. 248: 121–126. doi:10.1016/j.psychres.2016.12.003. ISSN 0165-1781.
  15. Nicolis GL, Modlinger RS, Gabrilove JL (1971). "A study of the histopathology of human gynecomastia". J Clin Endocrinol Metab. 32 (2): 173–8. doi:10.1210/jcem-32-2-173. PMID 5539033.