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A 17-year-old female complains to her pediatrician of bilateral knee pain, worse on the left side, for the last several months. She has also felt fatigued for some time. She has marked hepatosplenomegaly. Laboratory tests are obtained, leukocytes 3.4 / mm3, hematocrit 20%, hemoglobin 7.6 g/dL, platelets 150,000 / uL. Bone marrow biopsy reveals infiltration with foamy macrophages. What is the most likely accumulated storage product in this patient?

A- Ganglioside GM2
B- Glucosylceramide
C- Glycosaminoglycans
D- Glycogen
E- Sphingomyelin
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