Prevalence of Incidental Gynecomastia by Chest Computed Tomography in Patients with a Prediagnosis of COVID-19 Pneumonia

Abstract

Objective: In this study, we aimed to determine the prevalence of gynecomastia by evaluating computed tomography (CT) images of male patients who were admitted to our hospital during the coronavirus disease-2019 (COVID-19) pandemic.

Materials and methods: This study included a total of 1,877 patients who underwent chest CT for prediagnosis of COVID-19 pneumonia between March 15^th and May 15^th, 2020. All images were evaluated for the presence of gynecomastia. Gynecomastia patterns were evaluated according to morphological features, and diagnoses were made by measuring the largest glandular tissue diameter. Statistical analysis was performed with IBM SPSS software version 25.0.

Results: The prevalence of gynecomastia was 32.3%. In terms of pattern, 22% were nodular, 57% were dendritic, and 21% were diffuse glandular gynecomastia. A significant correlation was found between age and gynecomastia pattern (p<0.001). The incidence of nodular, dendritic, and diffuse glandular gynecomastia increased with advancing age. A significant difference was found in the analysis of the correlation between age groups and glandular tissue diameters (p<0.001). With an increase in glandular tissue diameter, the gynecomastia pattern changed from a nodular to a diffuse glandular pattern.

Conclusion: In our study, gynecomastia diagnosis was made through axial CT images. Although CT should not replace mammography and ultrasonography for clinical diagnosis of gynecomastia, chest CT scans can be used to evaluate patients with suspected gynecomastia.

Keywords: COVID-19; CT; Male breast; dendritic pattern; diffuse glandular pattern; gynecomastia; nodular pattern.

Figure 1

Computed tomography (CT) images showing axial diameter measurement of an 81-year-old patient with bilateral gynecomastia

Figure 2

Computed tomography images showing vertical growth of glandular tissue density with an axial diameter of 1–2 cm

Figure 3

CT images showing patterns of gynecomastia in the male breast. Examples of non-gynecomastic normal retroareolar area (a), nodular pattern (b), dendritic pattern (c), and diffuse glandular pattern (d) of gynecomastia CT: Computed tomography

Figure 4

Distribution of age according to gynecomastia pattern (1, nodular pattern; 2, dendritic pattern; 3, diffuse glandular pattern)

Figure 5

Pairwise comparisons of gynecomastia pattern (1, nodular pattern; 2, dendritic pattern; 3, diffuse glandular pattern) Std: Standard; Sig: Significance; Adj Sig: Adjusted significance

Figure 6

Relationship between age and glandular tissue diameter of right and left breast