Understanding the Origins of Focal Necrosis in My Liver
As a 33-year-old male, standing 5 feet 10 inches tall and weighing 200 pounds, I have a medical background that includes Crohn's disease and a recent diagnosis of Non-Hodgkin's lymphoma (specifically DLBCL). In my most recent PET/CT scan, I was informed that a small section of segment 6 of my liver exhibited hypodensity. It’s worth noting that my cancer has not metastasized to my liver, and apart from mild non-alcoholic fatty liver disease (NAFLD), my liver function appears to be satisfactory. I avoid any activities that might harm my liver health. This finding prompted my oncologist to schedule an MRI of my abdomen, which unfortunately did not yield any definitive results. Initially, my oncologist suspected a hemangioma, while the radiologist, who later performed a biopsy post-MRI, speculated that it could be an infection. Ultimately, the biopsy indicated the presence of focal necrosis, which essentially refers to a localized area of dead tissue—around 2 cm in size, if I recall correctly. This leaves me wondering about the cause behind this condition. To provide some context, I experienced a bowel perforation on January 8, 2025, which led to peritonitis and an urgent small bowel resection the same day. Following that event, my treatment regimen included one cycle of RCVP (Rituximab, Cyclophosphamide, Vincristine, and Prednisone), five cycles of Pola-R-CHP, and two cycles of Rituxan alone. My questions are: Is the focal necrosis a consequence of the peritonitis, the chemotherapy, or is it attributable to a different factor altogether?
Answers (1)
7/14/2025, 8:20:41 AM
OpenHealth AI
Focal necrosis in the liver can arise from various factors, especially considering your medical background involving Crohn's disease and recent treatment for Non-Hodgkin's lymphoma.
Key Points:
- Focal Necrosis Overview: Focal necrosis refers to localized tissue death which can stem from multiple causes including infections, vascular issues, and the effects of medications like chemotherapy.
- Possible Causes Related to Your Situation:
- Peritonitis and Bowel Perforation: This serious infection can lead to inflammation and subsequent necrosis in adjacent organs, including the liver.
- Chemotherapy: Certain chemotherapeutic agents can strain liver function or cause liver damage, potentially leading to ischemia (lack of blood flow) and necrosis.
- Fatty Liver Disease (NAFLD): Mild fatty liver can complicate liver function, particularly in the presence of other liver stressors.
Next Steps:
- Monitor Symptoms Closely: Pay attention to symptoms such as abdominal pain, changes in liver function test results, or any jaundice (yellowing of the skin/eyes). Document any new changes and bring them to your oncologist's attention.
- Discuss Causes with Your Oncologist: Schedule a follow-up to specifically address possible causes of the focal necrosis, exploring the roles of peritonitis, your treatment regimen, and your existing liver condition.
- Consider Imaging and Testing: Ask your doctor if further imaging (like a follow-up MRI or ultrasound) or lab tests (liver function tests) are necessary to monitor changes in the liver area and evaluate overall liver health.
- Maintain Liver Health: Continue avoiding alcohol and any medications or substances that may further burden your liver. A balanced diet rich in fruits, vegetables, and lean proteins can support liver function.
It's understandable to have concerns about your liver health, especially given your medical history. Establishing a close line of communication with your healthcare team will be crucial in unraveling the cause of the focal necrosis and ensuring appropriate management going forward.
Related Questions
Persistent Rash Dilemma: Seeking Clarity
I’m a 25-year-old woman, standing at 5'9" and weighing 70 kg. Currently, I am on a regimen that includes 50 mg of quetiapine daily and 225 mg of venlafaxine, which I genuinely dislike. Over the past three years, I have been struggling with a recurring rash that keeps cropping up in the same spot. If anyone has any insight into what this could possibly be, I would greatly appreciate your input, though I plan to consult with a general practitioner, which is obviously the first step. The rash tends to heal over the course of a few weeks only to reappear a few months later. Right now, it’s particularly bothersome because of the intense itching. It burns and itches quite a bit, making it very uncomfortable to deal with. Any help would be immensely valuable!
Uncertainty About a Bump Near My Hairline
At 22, I’ve been aware of this bump for quite a while—over the course of several years, in fact. It’s not painful, doesn't change in size, and remains exactly how it has always been. Nonetheless, I can’t shake off the concern that it might indicate a serious issue. Additionally, I’ve frequently noticed in various videos and images that lymph nodes in the neck are typically situated lower down. In my case, this bump is located directly behind my ears, close to my hairline. This discrepancy adds to my confusion, leading me to question whether it’s a lymph node or perhaps a normal feature of my skull. On the opposite side of my head, everything feels smooth, with no sign of a similar bump. I’m curious if lymph nodes can vary in their positioning from person to person or if they consistently occupy the same places. Is it common for lymph nodes to swell on both sides, or could it happen on just one side occasionally? If it is a lymph node, could it maintain its current size for an extended period? I’m seeking any insights or advice regarding this situation!
Ongoing Symptoms at 29
Several months back, I began experiencing persistent discomfort in my right testicle, a sensation that has yet to subside. Recently, over the past two to three weeks, I've noticed a sharp stinging feeling following urination. In addition, I've been dealing with a nagging ache in my lower back ever since this urination issue began. I've undergone three urine examinations, all of which have returned negative results for a urinary tract infection. At this point, I'm uncertain about what actions to take next or what might be causing these symptoms. :(
Is There Diagnostic Value in Elevated TNF Alpha Levels?
F24 Currently, I am experiencing a range of symptoms that include: - Widespread muscle twitching, also known as fasciculations, which initially began near my eyes and have since spread throughout my body. - Persistent fatigue, along with pain and weakness, particularly in my legs. - Episodes of night sweats that have lasted for several weeks. - Unintentional weight loss. - A noticeable decline in my immune system, evidenced by three urinary tract infections this month. - A mild feverish sensation and low-grade fevers during the evening hours. - Digestive troubles such as bloating, stomach pain, loss of appetite, and diarrhea. - Muscle aches, joint discomfort, and occasional headaches. - Intermittent difficulties with coordination and speech. Regular blood tests, including thyroid-stimulating hormone (TSH) levels and complete blood count, yielded normal results. However, during a consultation with a private physician, I received some "abnormal" findings: - Elevated TNF alpha levels, - Increased levels of M3 muscarinic acetylcholine receptor autoantibodies, - Extremely high concentrations of vitamin B12. The doctor indicated that these results suggest there may be moderate systemic inflammation, but he could not determine the underlying cause. Do these findings have legitimate significance, and should I consider discussing this further with my general practitioner?
Seeking Insights on Unexplained Body Pain After Negative ANA Test
I am a 32-year-old Asian female who has been managing depression and anxiety since 2020. Recently, in 2023, I was also diagnosed with ADHD. My current medication regimen includes Cymbalta (60mg), Ritalin (10mg twice daily—previously on Concerta 18mg), Seroquel (25mg), Ativan (0.5mg), and Glucophage XR (500mg). In late 2017, I began experiencing severe discomfort in my scapula that radiated to my clavicle, accompanied by debilitating headaches and occasional breathing difficulties. Over time, this localized pain evolved into widespread body aches, making me feel as though I have exerted myself through strenuous physical labor every single day. During my monthly visits to my psychiatrist, I consistently reported these issues, prompting her to refer me to an internal medicine specialist. She ordered an ANA test, suspecting potential autoimmune conditions, hypothyroidism, or PCOS due to my long history of irregular menstrual cycles (only three in the past year), acne, significant hair thinning, and my struggles to lose weight despite being in a calorie deficit. Since beginning Glucophage in March, I have managed to shed 9kg (20lbs), reducing my weight from 88kg (194lbs) to 79kg (174lbs). However, when the ANA test results came back negative, the doctor stated there were no further tests necessary, and he referred me to a gynecologist for further evaluation scheduled for next week. I mentioned that my psychiatrist, who is also of Asian descent, has a diagnosis of ankylosing spondylitis despite her negative ANA test results, but the doctor suggested my issues might stem from poor sleep quality instead. This persistent pain has significantly impacted my social life; I often decline invitations from friends, leading to a decline in social interactions and exacerbating my feelings of depression. My headaches, bodily pain, fatigue, and low energy can persist for weeks, even with medication adjustments including amitriptyline and Topamax. At times, I question whether my experiences are legitimate or if I’m simply being lazy, as my lifestyle has turned largely sedentary due to the pain I endure. To the doctors of Reddit, what recommendations can you offer? Do you have any insights into what this might be?