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Dr. Dan C. Martin's
Clinical Practice is at:
UT Medical Group, Inc.
7945 Wolf River Blvd
Suite 320
Germantown,
TN 38138
Phone (901) 347-8331
Fax (901) 347-8188
    

 

 

Other Problems with an
Appearance like Endometriosis

From
Laparoscopic Appearance of Endometriosis
Color Atlas
©1990 The Fertility Institute of the Mid-South

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Links to a low resolution PDF version of the Laparoscopic Appearance of Endometriosis Color Atlas is at Color Atlas LAE 1990.

Higher resolution pages are on the links below.

 

 

Page 26.  Chocolate cysts may also be corpus lutea. These frequently have clots within them or may have a yellowish rim. The clot may be firmly attached or may be easy to strip away from the wall of the cyst.

The biopsy shows diffuse hemosiderin laden macrophages associated with an involuting corpus luteum.  Macrophages can scatter throughout the granulosa lining, accumulate at the base of the old granulosa lining or accumulate at the surface. 

 

Page 27.  Low power density CO2 laser vaporization can leave carbon on top of residual endometriosis. This is particularly true in areas such as the broad ligament immediately overlying the ureter.

The biopsy shows carbon and granulation tissue directly above the endometriosis seen in the scarred right lower area of the specimen.

 

Page 28.  This area was resected at second look laparoscopy for persistent pain following CO2 laser vaporization.

The biopsy shows granulation tissue lying over the residual endometriosis. High power density CO2 laser vaporization can avoid carbonization.  However, resection is a more predictable technique. 

 

Page 29.  Scarred black areas are not always endometriosis. The right uterosacral lesion is foreign body and the black lesion in the left uterosacral is endometriosis. 

The biopsy shows old suture material in the right uterosacral ligament lesion. This was associated with scarring.

 

Page 30.  A diffuse red and brown appearance is seen in this patient, who has a high chlamydia IGG titer 1: 128, but no other identified pathology.

The biopsy shows diffuse dystrophic calcification (psammoma bodies).  This can occur in patients with high chlamydia IGG titers.

 

Page 31.  A black vesicle is in the right cul-de-sac. This vesicle is nonspecific and appears to be an old inflammatory epithelial inclusion.

The biopsy shows a flat lining at a high magnification view. Psammoma bodies are associated with this inclusion. This was in association with a borderline positive chlamydia IGG titer of 1:16.

 

Page 32.  Clear and white vesicles on the tube are rarely endometriosis. However, when the lesions are lateral to the tube, the diagnosis may be endometriosis as is seen on page 14.

The biopsy shows Walthard Rests that have been present since birth.  These are common congenital variants.

 

Page 33.  These small red lesions in the deep cul-de-sac appear like endometriosis. However, the appearance is more uniform than usual for endometriosis.

The biopsy shows highly vascular structures compatible with hemangiomas and show no signs of endometrial glands, stroma or epithelial lining.

 

Page 34.  Hemorrhagic red lesions were seen in this patient four weeks following a salpingotomy for the excision of a right tubal pregnancy. At this time, her HCG titer was rising due to her persistent ectopic pregnancy. (From Reich, et al. Fertility and Sterility 52: 338, 1989, with permission)

The biopsy shows clot, hemorrhage and villi from the reimplanted trophoblastic tissue in this cul-de-sac pregnancy.

 

Page 35.  Although some white nodules have been endometriosis, these can represent many lesion types. These large nodules were seen in a patient as part of a Interleukin-2 study protocol for recurrent breast cancer.

The biopsy shows metastatic breast cancer in all resected white nodules. On palpation, these had the same feel as fibrotic endometriosis.

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Last modified: November 03, 2007