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男性乳房发育症

2019-07-18 佚名 中国超声医学

男性乳房发育症(Gynecomastia),医学上是指男孩或成年男性的乳房异常发育现象。目前认为所有的男性乳腺发育都是由于雌激素分泌增多或雄激素/雌激素比值降低或对雌激素敏感度增强所致。

男性乳房发育症(Gynecomastia),医学上是指男孩或成年男性的乳房异常发育现象。目前认为所有的男性乳腺发育都是由于雌激素分泌增多或雄激素/雌激素比值降低或对雌激素敏感度增强所致。

致病原因

男性乳房发育症按病因可以分为生理性、病理性、药物性和特发性4种,其中以生理性最为多见。

男婴和青春期男孩,生理性的乳房发育,大都可以自然恢复的。对于乳房持续发育的成人,病因则相对复杂。

临床特点

症状

·乳房膨隆肿胀;

·部分伴有疼痛;

·偶见乳头溢液。



体征

·单侧或者双侧乳房发育增生、外观膨隆;

·乳头深面可触及圆盘状硬性结节;

·肿块触痛;

·质地相对质韧;

·少数患者挤压乳头可以产生白色分泌物。

·分类按乳房的大小以及有无多余皮肤,将男性乳房发育分为三级四度(Simon标准):

  I 级:腺体轻度肥大,无皮肤增多;

  IIa 级:腺体中度肥大,无皮肤增多;

  IIb 级:腺体中度肥大,伴皮肤增多;

  Ⅲ 级:腺体重度肥大,伴皮肤增多。



超声学检查

B超检查呈现如下声学影像特点:

  多表现以乳头为中心的扇形低回声;

  内见导管样回声向乳头方向聚拢,分布较规律;

  乳腺质地较韧,探头稍加压时其形态仍可变;

  内部血流不丰富。


B超图像)

临床实践中,医师必要时会将B超检查与X线钼靶摄片检查结合使用,可以获得更加精准的诊断与治疗意见。


(钼靶与B超检查组合图像)

鉴别诊断

·假性男性乳房发育症 (Pseudogynecomastia)

  肥胖人群中多见;

  乳房外观呈现女乳型;

  乳房膨隆为局部脂肪堆积所致;

  乳房无明显腺体发育现象。


(假性男性乳房发育症模式图)

·男性乳房癌 (Male Breast Cancer)

  好发于老年男性人群;

  乳房无痛性肿块;

  肿块坚实、边界不清、活动度差;
  
  可能乳头凹陷或血性溢液;

  腋下淋巴结肿大。


(男性乳房癌钼靶摄片)

治疗

·新生儿男孩人群中

乳房发育是由经胎盘途径获得的女性荷尔蒙致使乳房发育,症状轻微。

保守观察治疗,通常在1~3周内均会自行消退,偶见可持续数月甚至数年。

·青少年男孩人群中

由于这个年龄阶段荷尔蒙水平正常的变化,从而可能导致约30%~60%男性产生一过性乳房发育,这种情况持续时间短则几个月,长则2年,多数能够在1年内自行恢复到正常状态,约5%的青春期男性乳房发育症不能自行消退。

若患者乳房增大迅速或局部疼痛明显,须前往医生处就诊治疗。

·成年男性人群中

乳房发育的致病通常是由某些相关的疾病或某些药物诱发。在这些情况下,治疗相关疾病或停止使用相关药物通常可以使早期的乳房异常发育自行消失。

若乳房发育已经持续一年以上,药物治疗无效,可手术治疗。

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    2020-11-23 冷小落

    学习了

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=901348, encodeId=273a9013480f, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200807/fb49ede2bc714e14abb1a1024e3f6969/ca936d1263ab48ffba726dafc70bcdb2.jpg, createdBy=92c35391508, createdName=冷小落, createdTime=Mon Nov 23 09:06:28 CST 2020, time=2020-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=370186, encodeId=01a43e018623, content=正好今天有一个这样的病人入住病房,可以把理论与实践完美结合进一步学习了,赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2018/12/05/9151d1e89e73add788e7d96c55fb5dec.jpg, createdBy=dcfd2497546, createdName=124902dfm95暂无昵称, createdTime=Wed Jul 24 07:20:06 CST 2019, time=2019-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1347416, encodeId=435b134e41613, content=<a href='/topic/show?id=88713e938c1' target=_blank style='color:#2F92EE;'>#发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37938, encryptionId=88713e938c1, topicName=发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4c124, createdName=neurowu, createdTime=Fri Jul 19 16:22:00 CST 2019, time=2019-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516511, encodeId=5e141516511ee, content=<a href='/topic/show?id=482223624f0' target=_blank style='color:#2F92EE;'>#乳房发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23624, encryptionId=482223624f0, topicName=乳房发育)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=529d10977415, createdName=12498dabm80暂无昵称, createdTime=Fri Jul 19 16:22:00 CST 2019, time=2019-07-19, status=1, ipAttribution=)]
    2019-07-24 124902dfm95暂无昵称

    正好今天有一个这样的病人入住病房,可以把理论与实践完美结合进一步学习了,赞

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=901348, encodeId=273a9013480f, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200807/fb49ede2bc714e14abb1a1024e3f6969/ca936d1263ab48ffba726dafc70bcdb2.jpg, createdBy=92c35391508, createdName=冷小落, createdTime=Mon Nov 23 09:06:28 CST 2020, time=2020-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=370186, encodeId=01a43e018623, content=正好今天有一个这样的病人入住病房,可以把理论与实践完美结合进一步学习了,赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2018/12/05/9151d1e89e73add788e7d96c55fb5dec.jpg, createdBy=dcfd2497546, createdName=124902dfm95暂无昵称, createdTime=Wed Jul 24 07:20:06 CST 2019, time=2019-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1347416, encodeId=435b134e41613, content=<a href='/topic/show?id=88713e938c1' target=_blank style='color:#2F92EE;'>#发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37938, encryptionId=88713e938c1, topicName=发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4c124, createdName=neurowu, createdTime=Fri Jul 19 16:22:00 CST 2019, time=2019-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516511, encodeId=5e141516511ee, content=<a href='/topic/show?id=482223624f0' target=_blank style='color:#2F92EE;'>#乳房发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23624, encryptionId=482223624f0, topicName=乳房发育)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=529d10977415, createdName=12498dabm80暂无昵称, createdTime=Fri Jul 19 16:22:00 CST 2019, time=2019-07-19, status=1, ipAttribution=)]
    2019-07-19 neurowu
  4. [GetPortalCommentsPageByObjectIdResponse(id=901348, encodeId=273a9013480f, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200807/fb49ede2bc714e14abb1a1024e3f6969/ca936d1263ab48ffba726dafc70bcdb2.jpg, createdBy=92c35391508, createdName=冷小落, createdTime=Mon Nov 23 09:06:28 CST 2020, time=2020-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=370186, encodeId=01a43e018623, content=正好今天有一个这样的病人入住病房,可以把理论与实践完美结合进一步学习了,赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2018/12/05/9151d1e89e73add788e7d96c55fb5dec.jpg, createdBy=dcfd2497546, createdName=124902dfm95暂无昵称, createdTime=Wed Jul 24 07:20:06 CST 2019, time=2019-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1347416, encodeId=435b134e41613, content=<a href='/topic/show?id=88713e938c1' target=_blank style='color:#2F92EE;'>#发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37938, encryptionId=88713e938c1, topicName=发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4c124, createdName=neurowu, createdTime=Fri Jul 19 16:22:00 CST 2019, time=2019-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516511, encodeId=5e141516511ee, content=<a href='/topic/show?id=482223624f0' target=_blank style='color:#2F92EE;'>#乳房发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23624, encryptionId=482223624f0, topicName=乳房发育)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=529d10977415, createdName=12498dabm80暂无昵称, createdTime=Fri Jul 19 16:22:00 CST 2019, time=2019-07-19, status=1, ipAttribution=)]

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