ABSTRACT
Idiopathic gynecomastia occurs with persistence of low T/E1 and T/E2 ratios after puberty. Men with liver disease have gynecomastia, as a consequence of impaired hepatic steroid metabolism. In Egyptian patients with schistosomal hepatic fibrosis, gynecomastia is not an uncommon condition. To study the estrogen receptors in breast tissue in gynecomastia associated with schistosomal hepatic fibro sis compared to idiopathic gynecomastia. The study included 10 males with gynecomastia associated with schistosomal hepatic fibrosis [group A] and 8 patients with idiopathic gynecomastia free of liver disease. Mammary tissue, obtained via surgical excision was submitted to histopathological examination. The mean values of the plasma testosterone in the groups A and B, were 8 +/- 2.6 ng/ml and 5.7 +/- 2 ng/ml respectively. The difference was statistically insignificant [p = 0.058]. The mean values of serum estradiol were 45 +/- 24 pg/ml for group A and 24 +/- 9 pg/ml for group B. In group A there was characteristic lymphocytic and histocytic infiltration, with less fibrous reaction in the stromal tissue than it was in group B. ER status showed positivity in 67% of cases including 5/10 [50%] in group A and 7/8 [88%] in group B. It appeared in the form of reddish nuclear staining in 10 patients and cytoplasmic in two patients who were both in group B. The ER positivity was found to be significantly lower in patients of group A than it is in those of group B