•  The blue arrows point to a typical "endometrial type" gland.

•  The adjacent stroma contains spindly endometrial stroma.

•  Together they resemble inactive endometrium.

• unknown

• hypotheses include retrograde menstruation with implantation, metaplasia of the pelvic peritoneum (Mullerian derivative) or lymphovascular invasion

• reproductive age women esp 4th and 5th decade

• often associated with infertility without evidence of actual tubal obstruction

• may be asymptomatic or experience severe pelvic pain with menstruation, dyspareunia, dysuria, or pain on defecation

• therapy is dependent on symptoms and whether or not there is a desire to maintain fertility

• cortical surface may be dull with adhesions

• cysts contain old brown blood "chocolate"

• generally unilocular

• granular, shaggy brown lining

• also affects pelvic and uterine ligaments, cul-de-sac, peritoneum, abdominal scars and occasionally distant sites

• endometrial glands and/or

• endometrial stroma and/or

• hemosiderin laden macrophages
(2 out of above 3)

• usually abundant scar

• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1054-1055

• Current literature from PubMed at National Library of Medicine