IS case 504: Gamna-Gandy bodies

Richard Gong, MD

University of Rochester

Imaging Sciences URMC 2010
Publication Date: 2010-09-10

History

Patient is a 53-year-old female with end stage liver disease presenting for pre-transplant work-up.

Findings

Ultrasound showed multiple small hyperechoic foci throughout the enlarged spleen. CT showed multiple hyperdense lesions throughout the enlarged spleen. MRI showed multiple hypointense T1 and T2 lesions throughout the enlarged spleen. The CT and MRI images also showed incidental small gallstones.

Diagnosis

Gamna-Gandy bodies

Discussion

Gamna-Gandy bodies (siderotic nodules) are foci of microhemorrhages in the spleen due to portal hypertension. They contain fibrous tissue, hemosiderin and calcium. On ultrasound, they appear as hyperechoic foci. In one study, Gamna-Gandy bodies greater than 1 mm can be identified by ultrasound. CT will show multiple punctate high attenuation lesions in the spleen due to the calcifications and hemosiderin. MRI is superior to ultrasound and CT in the detection of Gamna-Gandy bodies. They are hypointense on all imaging sequences. T2 and gadolinium-enhanced T1 sequences will increase their detectability. The lesions themselves do not enhance.

Gamna-Gandy bodies must be differentiated from other entities seen as multiple hypointensities on MR images such as prominent vessels, calcified miliary tuberculosis, histoplasmosis, phleboliths, and microabscesses.

References

Sagoh T, Itoh K, Togashi K, et al. Gamna-Gandy bodies of the spleen: evaluation with MR imaging. Radiology. 1989 Sep;172(3):685-7. PMID: 2672093
Minami M, Itai Y, Ohtomo K, et al. Siderotic nodules in the spleen: MR imaging of portal hypertension. Radiology. 1989 Sep;172(3):681-4. PMID: 2672092