most commonly - endometriotric deposits are multiple small (<1cm) raised blue-black nodules - they appear as if ink has been injected under the peritoneum. If the condition is severe then the nodules may be larger and surrounded by variable amounts of fibrosis
other 'atypical/subtle' lesions commonly seen include red implants (petechial, vesicular, polypoid, haemorrhagic, red flame-like) and serous or clear vesicles (1)
involvement of the ovary may lead to the formation of an endometrioma (chocolate cyst)
deep infiltrating nodules extend more than 5mm below the peritoneal surface and may penetrate or adhere to other structures (eg. bowel, bladder, ureters, vagina) (1)
extensive pelvic damage due to fibrosis and adhesions may occur in chronic disease
microscopically endometriotic deposits contain glands and stroma. There is also a variable amount of fibrosis and bleeding. The endometriotic deposits may be out of phase with the woman's menstrual cycle. However, like normal endometrial tissue, the deposits decidualize during pregnancy
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