Gynecomastia pictures

Gynecomastia (GYN) is a clinical medical symptom caused by abnormal growth and development of male breast tissue and abnormal proliferation of breast connective tissue due to physiological or physiological factors causing an imbalance in the ratio of estrogen and male hormone. GYN is the most common male breast disease, accounting for approximately 80% to 90% of male breast disease.

The clinical manifestations are usually painless, idiopathic enlargement of one or both breasts or a tender lump in the subnipple area. 50% of GYN is physiological, and is more common in infancy and puberty. GYN at this time is usually short-lived and generally good. However, if it occurs before puberty, young people and middle-aged and elderly people are often found to be abnormal, further testing is required to eliminate the possibility of breast cancer or other new microorganisms.

GYN can occur at any age, but is most common between the ages of 12 and 17. In recent years, with the improvement of people's living standards and changes in daily life styles, the prevalence and medical treatment rates of this disease have increased significantly. The prevalence rates reported by each family vary from 30% to 70%, and there are certain differences in the prevalence rates at different ages. Reference literature reports that the post-mortem detection rate of GYN is 40% to 55% [1]. Rohrich reported that the incidence rate of GYN in men is 32% to 65% [2]. Chen Zhangqing [3] et al. reported that the incidence rate of GYN in newborn infants is about more than 50%, the incidence rate of GYN in adolescence is about 39%, and the incidence rate of GYN in the elderly is more than 40%. [4-6]

Pathogenesis

At present, it is believed that GYN is mainly caused by the disorder of estrogen levels in the blood circulation. There are basically two situations of disordered estrogen levels: one is an increase in estrogen, and the other is an increase in the ratio of estrogen/male hormone. On the one hand, rising estrogen can promote the growth and development of men's breasts. On the other hand, the increase in the estrogen/androgen ratio can also stimulate the production of sex estrogen fusion protein (SHBG). SHBG and androgen are much more potent than estrogen, so the ratio of biologically active dispersed estrogen/androgen in the blood increases, promoting breast hyperplasia [3].

In addition, some people believe that the production of GYN is also related to the estrogen/androgen ratio in the mammary gland and the response of the mammary gland to growth hormone. In some cases, the aromatase specificity of the mammary gland increases, causing a large amount of male hormones to be converted into estrogen, and in some cases, excessive estrogen causes GYN. Sometimes, although the level of estrogen in the blood circulation is normal, the response of the breast tissue to growth hormone has changed. For example, the androgen kinase (AR) is not sensitive to testosterone or the estrogen receptor (ER) is more sensitive to estradiol, and the effect of androgens is weakened, while the effect of estrogen is relatively increased, leading to breast hyperplasia. For example, Xu Peiheng et al. [7] reported that the levels of estradiol and testosterone in the blood cells of GYN patients were not significantly different from the control experiment, and the AR fusion volume was significantly smaller than the control experiment. It is believed that GYN is caused by the reduction of AR, which prevents the molecular function of testosterone from being fully exerted normally.

Recently, new discoveries have been made about the generation mechanism of GYN. Pensler et al [8] studied 34 adolescent GYN patients with Klinefelter syndrome, and their breast ER and estrogen kinase (PR) expression increased, suggesting that the generation of GYN is related to the expression of breast hormone kinase. Qin Bing et al. [9] used immune tissue electrochemiluminescence to examine the expression of heat shock protein 70 (HSP70) in the breast tissue of 25 GYN patients and found that the detection rate of HSP70 was 72%, which was similar to the expression rate in breast cancer tissue, suggesting that the production of GYN is closely related to cell proliferation. Zhao Guofa et al. [10] believe that GYN is actually an inflammatory reaction (non-infectious) caused by the target organ (breast tissue) under the stimulation of estrogen or the influence of other factors. The use of partial injection occlusion therapy with prednisolone acetate suspension can achieve good therapeutic effects.