Ans. is ai.e. B/L chocolate cyst of ovary "The ovary is the commonest site and is involved in 30-40% of cases. The lesion is nearly always bilateral. It sometimes appears as multiple burnt match head spots on the surface of the ovary and sometimes as the typical tarry cysts in a disorganised organ surrounded by dense adhesinos." They are true cystsdeg with columnar lining epithelium.deg The cysts enlarge with cyclic bleeding. The serum gets absorbed in between periods and the content inside becomes chocolate, tarry brown in colourdeg. Histology - Lining epithelium is columnar epitheliumdeg. - Beneath the epithelium are large macrophages called as Pseudoxanthoma cells which have brown cytoplasm due to ingested blood pigments like hemosiderin. Treatment of chocolate cyst / endometrioma. Small < 3cm Large > 3cm Laparoscopic aspiration/ Associated with extensive adhesions to other pelvic Laparoscopic cystectomy structures and therefore laparotomy is necessary. Other conditions associated with Endometriosis Anovulationdeg Abnormal follicular development Reduced circulating E2 levels during pre ovulatory phasedeg Disturbed LH surge patternsdeg Premenstrual spottingdeg Luteinized unruptured follicle syndromedeg Hyperprolactinemiadeg Galactorrheadeg Before concluding lets rule out other options. Adenomyosis is associated with endometriosis but vice versa is not true: similarly fibroid uterus is associated with endometriosis but vice versa is not true (Ruling out options "b" and "c"). Multiple luteal cysts in the ovary are seen in case of : a. Pregnancy Multiple pregnancydeg HCG therapydeg H. Moledeg Chorio carcinomadeg Thus option "d" is incorrect. There is no association between endometritis and endometriosis.