Abstract:

Objective: To examine the incidence of gynecomastia detected by chest computed tomography (CT) in the adult male population and its association with fatty liver disease, abdominal wall, and retrorenal and subcutaneous fatty tissue thickness. Methods: Chest CT scans of 1,191 patients were scanned retrospectively. One hundred fifty-eight cases with a fibroglandular tissue diameter (FGTD) of more than 2 cm were accepted as gynecomastia. Forty-five cases with FGTD less than 1 cm constituted the control group. Patterns of gynecomastia, FGTD, the subcutaneous adipose tissue thickness of breast (B-ATT), abdominal wall (AW-ATT) and retrorenal adipose tissue thickness (RR-ATT) were measured in mm. Additionally, the Hounsfield unit attenuation of the liver and spleen was obtained, and a liver-to-spleen (L/S) ratio below 0.8 was considered hepatosteatosis. The correlation between all these parameters was analysed by Kendall’s Tau-b. Results: The incidence of gynecomastia was calculated as 13.2% (158/1,191), observed bilateral in 84.2% (n=133) and unilateral in 15.8% (n=25) of the cases. The dendritic pattern was the most observed type, with 57.6% (n=91) of the cases. There was a significant difference between B-ATT, AW-ATT, and RR-AAT values and gynecomastia (p<0.005), but a weak relationship was observed (r=0.137, r=0.132, r=0.098, respectively). When the study population was divided into two groups according to the L/S ratio, no significant difference was found, regarding FGTD and all the adipose tissue thickness parameters (p>0.05). Conclusion: Gynecomastia may signify visceral obesity rather than innocent hypertrophy. In clinical practice, incidental detection of gynecomastia by CT can play a useful role in case management.

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