A. Ovarian teratoma
C. Ovarian mucinous Cystadenoma
D. Pelvic inflammatory disease
Image shows:Ovarian endometriosis. Sectioning of ovary reveals a large endometriotic cyst with degenerated blood (“chocolate cyst”).
- Endometriosis is defined by the presence of endometrial glands and stroma in a location outside the endomyometrium.
- It frequently is multifocal and often involves pelvic structures (ovaries, pouch of Douglas, uterine ligaments, tubes, and rectovaginal septum).
- In contrast with adenomyosis, endometriosis almost always contains functioning endometrium, which undergoes cyclic bleeding.
- Because blood collects in these aberrant foci, they usually appear grossly as red-brown nodules or implants.
- They range in size from microscopic to 1 to 2 cm in diameter and lie on or just under the affected serosal surface.
- When the ovaries are involved, the lesions may form large, blood-filled cysts that turn brown (chocolate cysts) as the blood ages .
- With seepage and organization of the blood, widespread fibrosis occurs, leading to adhesions among pelvic structures, sealing of the tubal fimbriated ends, and distortion of the oviducts and ovaries.
- The histologic diagnosis at all sites depends on finding two of the following three features within the lesions: endometrial glands, endometrial stroma, and hemosiderin pigment.