Male breast abscess is an extremely rare benign lesion with few published literatures and reported cases. Due to its rarity, little has been reported about its clinical or imaging features. In this report, we present a 60-year old male patient with idiopathic breast subareolar abscess mimicking malignancy in the clinical, mammography, ultrasound, and shear-wave elastography findings. Although rare, abscess should be kept in the differential diagnosis of male breast subareolar lesions mimicking malignancy.

Introduction: The hyperimmune malarial splenomegaly is the tropical idiopathic splenomegaly (Charmot, 1959) and tropical splenomegaly syndrome (Pitney, 1968). It is linked to aberrant hyperimmune reaction to repeated malaria infections and prolonged. This article is aimed at reviewing the clinical aspects of HMS.

Observation: Here is a case of patient aged 43, Congolese, who was seen in consultation for splenomegaly. This splenomegaly was diagnosed several months before, fortuitously, on the occasion of an assessment for arthralgia and lumbago. The search of hamatozoon by sanguine smear-thick drop was positive with a parasitemy lesser than 1%. The patient has benefited of curative antimalarial treatment. After three months of treatment, splenomegaly was then measuring 9cm at ultrasound. 3 months later, the spleen was just palpable.

Conclusion: The HMS is the phase state of a specific hyper responsiveness syndrome of malaria infection. It follows the iterative Plasmodium infections for several years. This diagnosis should be evoked in patients who have lived for several years in a malaria-endemic country and present themselves with splenomegaly associated with a sharp increase in IgM. After usual antimalarial curative treatment, splenomegaly regressed in several months.

Objective: The study aimed to describe shear wave elastographic characteristics differentiating benign and malignant breast lumps and to establish a combined scoring system to make a diagnosis.

Material & methods: All patients over 15 years of age presented with breast lumps were included. Shear wave elastography was done by using Aixpslorer Ultrasound System Multiwave version 8.2.0 (Supersonic Imagine S.A. Aix-en-Provence, France) with Superlinear TM (SL15-4* 50 mm Super Linear Array) probe. Qualitative assessment was done on color code (ie blue, yellow, orange, red and dark red) and presence of signal void dark area. Quantitative assessment was taken in Kilopascals (KPA), where KPA mean was taken from the darkest area. All patients underwent biopsy to confirm histopathology. Each parameter was individually correlated with histopathological diagnosis; broadly categorized into benign and malignant lesions. Finally the parameters were combined to see if combination further improves diagnostic accuracy.

Results: A total of 109 patients with breast lumps were included. The dark red color code, presence of signal void area and the mean KPA >250 were independent predictors of malignant histopathology. The benign lesions showed low mean KPA and blue color code without any signal void area with exception of breast abscess. Combine score system has potential to accurately define nature of breast lumps, where score 1 defines benign and 3 defines malignant lesions, while in score 2 a great majority was malignant but a few benign lesions also fall into this category.

Conclusion: Breast lumps undergoing shear wave elastography if scored 1 having blue to orange color code, KPA