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splenic siderotic nodule

Tuesday 4 October 2011

Gamna-Gandy body; Gamna-Gandy nodules

Definition : Splenic siderotic nodules, also known as Gamna-Gandy bodies, of the spleen, are most commonly encountered in portal hypertension. The pathophysiological process is the result of microhaemorrhage resulting in haemosiderin and calcium deposition followed by fibroblastic reaction.

Grossly, Gamna-Gandy bodies are characterised by many well-circumscribed nodules measuring several millimetres, with a dark haemorrhagic centre surrounded by a pale inner hyperaemic rim and a dark outer rim. This gives an appearance resembling "tobacco flecks".

Histologically, there is deposition of haemosiderin and calcium within the connective tissue stroma and vessels with a fibroblastic reaction, leading to microarchitectural distortion.

Etiology - Associations

- portal hypertension

  • per se, or caused by portal or splenic vein thrombosis

- paroxysmal nocturnal haemoglobinuria
- sickle cell anaemia
- haemolytic anaemias
- leukaemias
-  lymphomas
- patients receiving blood transfusions
- acquired haemochromatosis
- splenic haemangiomatosis - diffuse splenic haemangiomatosis
- splenic neoplasms

- malignant - angiosarcoma of the spleen
- cardiac myxomas
- hepatosplenic schistosomiasis

See also

- splenic anomalies
- siderotic nodule
- splenic nodule