Gamna-Gandy Bodies: Definition and Management
Gamna-Gandy bodies are benign siderotic nodules in the spleen that represent organized foci of old hemorrhage and require no specific treatment—management is directed at the underlying cause of portal hypertension or splenic congestion. 1, 2, 3
What Are Gamna-Gandy Bodies?
Gamna-Gandy bodies are spheroidal yellow-brown foci consisting of dense fibrous tissue and collagenous fibers encrusted with iron pigments (hemosiderin) and calcium salts. 2 These siderotic nodules form from the organization of small hemorrhages within the spleen. 2
Key pathologic features include:
- Circumscribed nodules containing dark brown rod-shaped and "bamboo-shaped" fibrotic structures 1
- Positive staining with Perls stain (for iron) and von Kossa stain (for calcium) 1
- Historically mistaken for fungal infection due to their unusual appearance, but proven to be non-infectious organized hemorrhage 2
Clinical Associations
Gamna-Gandy bodies are most commonly associated with:
- Portal hypertension (the most common cause) 3, 4
- Liver cirrhosis 3, 4
- Portal vein or splenic vein thrombosis 4
- Hemolytic anemia 4
- Leukemia or lymphoma 4
- Patients receiving blood transfusions 4
- Acquired hemochromatosis 4
- Paroxysmal nocturnal hemoglobinuria 4
Less commonly, these bodies have been reported in atrial myxomas, lymph nodes, thymoma, thyroid adenoma, renal cell carcinoma, and rarely in CNS neoplasms or vascular malformations. 2
Diagnostic Imaging
MRI is the most sensitive imaging modality for detecting Gamna-Gandy bodies due to their iron content, which creates characteristic signal changes. 3, 4
CT and ultrasound can also detect these lesions:
- Unenhanced CT may show multiple faint high-attenuation spots representing calcifications within the nodules 5
- Ultrasonography can help in detection and characterization 3
Treatment Approach
No direct treatment is needed for Gamna-Gandy bodies themselves—they are an incidental finding that reflects chronic splenic congestion. 2, 3
Management should focus on:
- Identifying and treating the underlying cause (most commonly portal hypertension from liver cirrhosis) 3, 4
- Managing portal hypertension if present, using standard approaches for the underlying liver disease 3
- Monitoring for complications of the primary disease process (variceal bleeding, ascites, hepatic encephalopathy) 3
Important Clinical Pitfalls
Do not mistake Gamna-Gandy bodies for:
- Filamentous mycoses such as mucormycosis or phaeohyphomycosis (the "bamboo-shaped" structures can mimic fungal hyphae) 1
- Splenic metastases or primary splenic tumors 1
- Splenic abscesses or granulomas 1
The presence of Gamna-Gandy bodies should prompt evaluation for portal hypertension and its underlying causes if not already diagnosed. 3, 4