Gynecomastia in male HIV patients: MRI and US findings

Purpose: To evaluate the role of MRI and sonography in differential diagnosis between gynecomastia and lipomastia in adult male HIV patients treated with high-activity antiretroviral therapy (HAART) for guide management. Materials and Methods: Nineteen adult male HIV patients with enlargement of the breast, which developed during treatment with HAART, were examined with ultrasound (US) and magnetic resonance imaging (MRI). Results: MRI was performed with SPIR T2WI, depicted in 95% of the patients, true gynecomastia and in the remaining 5% lipomastia; US demonstrated in all patients, in the subareolar region, a hypoechoic area, but was enable to make a differential diagnosis between glandular tissue and fat accumulation. Conclusion: US and MRI scan should be advised in HIV-infected patient in antiretroviral therapy with enlargement of the breast, in order to assess the best choice in managing this clinical condition. MRI with fat saturation sequences clarifies the tissue distribution in the mammary gland and helps to assess the amount of fat accumulated in the breast.