In male patients, which finding is most typical of gynecomastia on ultrasound?

• A. Triangular Retroareolar Glandular Tissue With Parallel Orientation
• B. A Well-Circumscribed Oval Hypoechoic Mass
• C. A Complex Cyst
• D. Diffuse Skin Thickening Only

Answer: (A)

Gynecomastia in men is the proliferation of glandular tissue beneath the areola. On ultrasound it classically appears as a wedge- or triangle-shaped band of subareolar glandular tissue that lies directly behind the nipple and runs parallel to the chest wall. This retroareolar, parallel-oriented tissue is the hallmark pattern of gynecomastia and helps distinguish it from other findings. A well-circumscribed oval hypoechoic mass would suggest a discrete lesion rather than diffuse subareolar tissue, a complex cyst implies mixed cystic and solid components, and diffuse skin thickening alone is not the typical glandular proliferation seen in gynecomastia.