65-year-old man with pain and palpable lump behind the left nipple for a few months
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So our first patient is a 65-year-old man
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with pain and a palpable lump behind
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the left nipple for a few months.
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So we can see here that we ended up being
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able to get a fair amount of tissue on
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the MLO views bilaterally, and actually
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very little tissue on the CC views.
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And the other thing to notice is that
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there's a fair amount of tissue centered
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under the nipple in the left breast.
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And maybe a little bit on the right.
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Gynecomastia is often bilateral but asymmetric.
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So that's an important thing to look for.
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But, um, the area that the patient can feel on the
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left is probably related to this breast tissue.
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And this is consistent with gynecomastia.
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So for this patient, we did tomosynthesis imaging.
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So we can look through those images.
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And his nipple was marked with a BB, but you can
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see that there's, um, this tissue, uh, behind the
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nipple, and it is consistent with gynecomastia.
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So the opposite breast, just looking through
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that one, this nipple is marked here,
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there's some fatty tissue, there's really
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not any significant breast tissue there,
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a few little lymph nodes here and there.
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So, we also looked at his,
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uh, tissue with ultrasound.
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This is the left breast.
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You can see this hypoechoic tissue kind of
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extending out into the surrounding tissue.
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It's pretty vascular.
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Here it is kind of going out into the tissue.
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And then on the right side,
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we're really just seeing fatty tissue
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going all the way up to the nipple.
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Here's his nipple.
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There's not much there.
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So, this would be unilateral left gynecomastia.
Lisa Ann Mullen, MD
Assistant Professor; Breast Imaging Fellowship Director
Johns Hopkins Medicine
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