😲😲Gynocomastia😲😲

👌👌WHAT IS GYNAECOMASTIA?
👏👏গাইনোকোমাশ্চিয়া কি?
Enlargement of male breast due to proliferation of glandular components.
It is due to disturbance of normal ratio of active androgen to oestrogen in plasma or breast
(normal ratio of testosterone:oestrogen is 100:1 and normal ratio of these in blood is 300:1).
Imbalance occurs either due to less testosterone production or action or increased oestrogen
synthesis or both.

👌👌Causes(পুরুষের ব্রেস্ট বড় হওয়ার কারন)

Physiological
• Pubertal, may be unilateral due to transient increase in oestradiol level. Resolves spontane-
ously in 6–18 months.
• Senile, due to increased conversion of oestrogen from androgen (also less Leydig cell in testis).
• Newborn (due to transplacental transfer of maternal oestrogen).
Pathological

1. Chronic liver disease (common in alcoholic liver disease), HCC (hCG secreting).
2. Bronchial carcinoma (5% case, hCG-secreting).
3. Hypogonadism—
   – Primary testicular disease (testicular tumour, teratoma, Leydig cell tumour).
   – Testicular failure (trauma, orchidectomy, radiation, leprosy, TB, mumps orchitis, haemo-
   chromatosis, Klinefelter’s syndrome).
   – Secondary testicular failure (hypopituitarism, hyperprolactinaemia, Kallman’s syndrome).
4. Endocrine disease (acromegaly, thyrotoxicosis, hypothyroidism, adrenal carcinoma, Ad-
   dison’s disease).
5. Drugs—spironolactone, digoxin, INH, oestrogen therapy for prostate carcinoma, alcohol,
   alkylating agent, methyldopa, marijuana, amiodarone.
6. Chromosomal abnormalities—Klinefelter’s syndrome, Kallman’s syndrome.
7. Others—testicular feminisation syndrome, starvation, idiopathic.
   thanks for stay with me..@rubel24