Gamma Gandy Bodies.wmv

Gamma-Gandy Bodies (GGB): Sonogram of the spleen in a patient with portal hypertension demonstrates numerous small echogenic foci without acoustic shadowing.

Sonographic Features of GGB: On sonography, GGB are seen as punctuate, bright echogenic foci scattered in the parenchyma. They may or may not cause acoustic shadowing posterior to these foci depending on the amount of calcification present within them. Portal hypertension may also show the presence of reflector channels in the spleen, which is actually the sclerotic splenic vein wall secondary to portal hypertension. These channels may be distinguished from GGB by the presence of flow within them on color flow Doppler imaging. Unfortunately, most of these cases are missed on ultrasound by sonographers who are not aware of these nodules.
Gamna-Gandy bodies (also known as siderotic nodules or tobacco flecks) are small, firm nodules of fibrous tissue impregnated with iron pigment (hemosiderin) and calcium salts that occur chiefly in the spleen but more commonly in conditions such as congestive splenomegaly and sickle cell anemia. They have also been rarely reported in cardiac myxomas. The GGB in the spleen are thought to be a result of healed focal hemorrhages and necrosis in the splenic parenchyma secondary to congestive splenomegaly, followed by accumulation of hemosiderin and impregnation of collagen and elastic fibers with iron and calcium.

Origin of GGB. Gamna-Gandy bodies were first described by Marini in 1902. They were later reported by Charles Gandy (French physician) and Carlo Gamna (Italian physician) in 1905 and 1921, respectively, giving the eponym to the entity. Because of the resemblance of the histologic features of GGB to mycelial structures, these lesions were initially thought by some authors to have a fungal origin. The thought was completely discarded after definite microbiologic studies of GGB were published in 1931.

Causes of GGB. Portal hypertension is the most common cause of GGB in the spleen and is seen in about 9% to 12% of these patients. Gamna-Gandy bodies in the spleen have also been seen in conditions such as paroxysmal nocturnal hemoglobinuria, hemolytic anemia, sickle cell anemia, leukemia, and lymphoma, in patients receiving blood transfusions, in angiosarcoma, and in acquired hemochromatosis. However, it is not clear whether GGB in these conditions are a direct result of the condition themselves or are a result of underlying portal hypertension. Uncommonly, GGB have also been reported in other organs besides the spleen.

Category:

Education

Tags:

• portal
• hypertension
• gamma
• gandy
• bodies
• spleen
• ultrasound