GYNECOMASTIA – an increase in the mammary glands in men according to the type of women. Distinguish true, lies hydrochloric and juvenile gynecomastia. Is muddy Gynecomastia is bilateral, rarely unilateral, develops between the ages of 15-40 years.
False gynecomastia ( lipomastiya ) – before resents a bilateral symmetrical deposition of fat in the domain STI breast. Can crust drink dopubertatnogo , postpubertat Mr. and involution period, CCA cially in obese men. Accumulated of fat in the breast even called false gynecomastia, yet the vast majority of cases, s is observed at a low level functions of the testes and is the indirect nym symptom of hypogonadism . False gynecomastia is observed in young men with obesity, adiposogenital dystrophy.
Juvenile gynecomastia develops camping in boys during puberty, there is little time mers and, as a rule, with few exceptions, after the onset of lovogo maturation regresses.
Causes
The reason for this may be hyperproduction pituitary LTG ( lyuteinotropny hormone, prolactin), the excess you division estrogens at feminizing adrenal adenomas, syndrome Klinefelter , cryptorchidism, horionepitelioma testes ( Dzhilbera syndrome .).
Often poorly pronounced gynecomastia occurs when chronic hepatitis, in D result lower the Pec function or inactivates estrogens. Gynecomastia can occur and after The duration Nogo reception synthetic androgen drugs. At this time vitie gynecomastia due to liver failure to inactivate estrogens resulting from Metabo ism synthetic androgens. Gynecomastia pathogenesis .
It is a violation of androgenic –estrogennogo equilibrium with pre valirovaniem past.
Anatomically, the breast is clearly distinguished from neighboring TKA it: dense, often lobed. Mi -macroscopic distinguish two histo logical form:
- parenchymal transformation, whereby prois walks about the proliferation of mammary currents to form the lobules, jellies Zist tissue
- interstitial transformation, when there is proliferation and development unite tion tissue and fat deposition in the interstices and periductal TCA no.
More often there is a combinatorial tion of these two forms.
The clinical picture .
Halos with Skov increased, pigmentation, enlarged breasts napodo Bie women. In the initial period of development, it is often painful, and subsequently painless. Development of medical fief. Usually, gynecomastia is accompanied given hypogonadism .
TREATMENT.
- When pubertal gynecomastia should not spend a special treatment, since in the overwhelming the majority of cases the
- When gynecomastia in young and adult women in the initial perio de recommended the appointment of andro genes testosterone , etc., Which often can give a positive result.
- In cases of severe gynecomastia, surgical removal of the mammary glands for cosmetic reasons is recommended .
- To suppress LTH production, bromocriptine is recommended .
Gynecomastia malignant is extremely rare and not life threatening.