ABSTRACT
Ovarian endometriosisIn the ovary, endometriosis presents either as superficial haemorrhagic implants or in the more severe form as a haemorrhagic or ‘chocolate’ cyst. The histopathology of ovarian endometriosis is characterised by a large variation in the amount of endometrial tissue. The endometrial cyst can be lined by free endometrial tissue, histologically and functionally indistinguishable from eutopic endometrium, or all traces of endometrial tissue can be lost and the cyst wall covered by fibrotic and reactive tissue. Common superficial haemorrhagic implants are red vesicles or blebs, and the classical blue-black implants. Haemorrhagic implants are commonly associated with adhesion formation, sometimes covering a significant proportion of the ovary. The word ‘endometrioma’ is used to describe an endometriotic cyst of the ovary. The haemorrhagic content of the cyst is likely to originate from chronic bleeding from these small areas of free endometriosis.
