Autopsy of spleen of a patient with poal hypeension shows Gamna-Gandy bodies. It contains hemosiderin and:
**Core Concept:** Gamna-Gandy bodies are iron-rich inclusions found in macrophages of the spleen in patients with hemosiderosis. They are characterized by the presence of hemosiderin, a yellow-brown pigment resulting from the degradation of heme in senescent red blood cells (RBCs).
**Why the Correct Answer is Right:** In cases of poal hypertension (polycythemia vera), there is excessive production of red blood cells (RBCs) due to hyperplasia of the bone marrow. As a result, there is increased hemolysis (destruction) of RBCs, leading to a high number of senescent RBCs. These senescent RBCs contain heme, which is subsequently degraded into iron and bilirubin. In the spleen, macrophages engulf and store the iron from the hemosiderin, forming Gamna-Gandy bodies.
**Why Each Wrong Option is Incorrect:**
A. Hemosiderin is not present in macrophages of the liver in polycythemia vera. The correct answer demonstrates the presence of hemosiderin in spleen macrophages due to hemolysis.
B. Hemosiderin is not absent from macrophages of the spleen in polycythemia vera. This option contradicts the presence of hemosiderin in the correct answer.
C. While hemosiderosis is characterized by iron deposition in various organs, this option does not specifically address the location of hemosiderin accumulation in polycythemia vera.
D. This option does not address the presence of hemosiderin in macrophages of the spleen in polycythemia vera, and focuses on a different aspect of hemosiderosis.
**Clinical Pearl:** Polycythemia vera is a myeloproliferative disorder characterized by excessive production of RBCs, leading to increased hemolysis and accumulation of hemosiderin in the spleen (Gamna-Gandy bodies) as well as other organs like liver, bone marrow, and lungs. The presence of these bodies indicates chronic hemolysis and is a useful clue for diagnosing polycythemia vera.