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Splenic siderotic nodules

Last revised by Bruno Di Muzio ◉ on 10 Oct 2024

Citation, DOI, disclosures and article data

Citation:

Weerakkody Y, Di Muzio B, Campos A, et al. Splenic siderotic nodules. Reference article, Radiopaedia.org (Accessed on 19 Jan 2025) https://doi.org/10.53347/rID-16487

DOI:

https://doi.org/10.53347/rID-16487

Permalink:

https://radiopaedia.org/articles/16487

rID:

16487

Article created:

22 Jan 2012, Yuranga Weerakkody ◉

Disclosures:

At the time the article was created Yuranga Weerakkody had no recorded disclosures.

View Yuranga Weerakkody's current disclosures

Last revised:

10 Oct 2024, Bruno Di Muzio ◉

Disclosures:

At the time the article was last revised Bruno Di Muzio had no financial relationships to ineligible companies to disclose.

View Bruno Di Muzio's current disclosures

Revisions:

24 times, by 16 contributors - see full revision history and disclosures

Systems:

Gastrointestinal

Tags:

refs

Synonyms:

Siderotic nodules in spleen
Siderotic nodules in the spleen
Gamna-Gandy bodies
Splenic siderotic nodule
Gamna-Gandy body
Splenic siderosis

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

portal hypertension
- per se, or caused by portal or splenic vein thrombosis
paroxysmal nocturnal hemoglobinuria⁷
sickle cell anemia
hemolytic anemias ¹⁰
leukemia¹⁰
lymphoma ¹⁰
patients receiving blood transfusions¹⁰
acquired hemochromatosis
diffuse splenic haemangiomatosis
splenic neoplasms
- benign
  - littoral cell angioma of the spleen
  - hemangioendothelioma of the spleen
- malignant
  - splenic angiosarcoma
cardiac myxomas ⁸
hepatosplenic schistosomiasis⁵

Pathology

Grossly, Gamna-Gandy bodies are characterized by many well-circumscribed nodules measuring several millimeters, with a dark hemorrhagic center surrounded by a pale inner hyperemic rim and a dark outer rim. This gives an appearance resembling "tobacco flecks". Histologically, there is deposition of hemosiderin and calcium within the connective tissue stroma and vessels with a fibroblastic reaction, leading to microarchitectural distortion.

Radiographic features

Ultrasound

Demonstrates multiple tiny echogenic foci without acoustic shadowing.

CT

Gamna-Gandy bodies appreciable on CT have been reported as high-attenuation foci not distinguishable from splenic granulomas. They are rarely well demonstrated by CT ².

MRI

Siderotic foci (often less than 1 cm⁴) are punctate foci within the spleen. The high magnetic susceptibility effect of hemosiderin typically renders the siderotic foci markedly hypointense on certain sequences. Hence, signal characteristics of the nodules include:

T2: very low-signal
GRE/SWI: low-signal (considered the most sensitive sequence for detection of siderotic nodules ¹)

References

1. Chan YL, Yang WT, Sung JJ et-al. Diagnostic accuracy of abdominal ultrasonography compared to magnetic resonance imaging in siderosis of the spleen. J Ultrasound Med. 2000;19 (8): 543-7. J Ultrasound Med (abstract) - Pubmed citation
2. Luo TY, Itai Y, Yamaguchi M et-al. Gamna-gandy bodies of the spleen depicted by unenhanced CT: report of two cases. Radiat Med. 16 (6): 473-6. - Pubmed citation
3. Minami M, Itai Y, Ohtomo K et-al. Siderotic nodules in the spleen: MR imaging of portal hypertension. Radiology. 1989;172 (3): 681-4. Radiology (abstract) - Pubmed citation
4. Luna A, Ribes R, Caro P et-al. MRI of focal splenic lesions without and with dynamic gadolinium enhancement. AJR Am J Roentgenol. 2006;186 (6): 1533-47. doi:10.2214/AJR.04.1249 - Pubmed citation
5. Bezerra A, D'Ippolito G, Caldana R et al. Differentiating Cirrhosis and Chronic Hepatosplenic Schistosomiasis Using MRI. AJR Am J Roentgenol. 2008;190(3):W201-7. doi:10.2214/AJR.07.2639 - Pubmed
6. Eurorad teaching files : Case 7628 showing Gamma Gandy bodies
7. Roubidoux MA. MR of the kidneys, liver, and spleen in paroxysmal nocturnal hemoglobinuria. Abdom Imaging. 19 (2): 168-73. - Pubmed citation
8. Watanabe M, Takazawa K, Wada A et-al. Cardiac myxoma with Gamna-Gandy bodies: case report with MR imaging. J Thorac Imaging. 1994;9 (3): 185-7. - Pubmed citation
9. Sagoh T, Itoh K, Togashi K et al. Gamna-Gandy Bodies of the Spleen: Evaluation with MR Imaging. Radiology. 1989;172(3):685-7. doi:10.1148/radiology.172.3.2672093 - Pubmed
10. Dobritz M, NöMayr A, Bautz W et-al. Gamna-Gandy bodies of the spleen detected with MR imaging: a case report. Magn Reson Imaging. 2002;19 (9): 1249-51. Pubmed citation

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Splenic siderotic nodules

Citation, DOI, disclosures and article data

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Epidemiology

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Ultrasound

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