Endometriosis, abdominal wall

specimen
image, endometriosis

This obese woman in her thirties complained of an abdominal mass that her primary care doctor thought was an abscess. She was referred to a general surgeon for incision and drainage. The surgeon ruled out abscess by noting a three-month history of the complaint (abscesses are more acute processes) and by aspirating blood, rather than pus, from the lesion. As this was such a large and bothersome mass (the skin was about to break down over it) that the doctor decided to remove it surgically.

The specimen was a bloc of adipose tissue with a small ellipse of skin over it. The skin showed a scar from a previous Caesarian section, interrupted by a blood-filled cyst resembling a bleb, but slightly deeper. This was just the tip of the iceberg, as section of the subcutaneous tissue revealed a complex network of white fibrous bands interrupted by blood-filled cysts and patchy areas of interstitial hemorrhage. The photo above shows a central slice thorugh the specimen, with the small skin ellipse at top center. This slab measures 12 x 9.5 cm.

For the photo below, I moved in a little closer and immersed the specimen in a shallow pan of water. Whether it's better to shoot specimens dry or immersed is a matter of taste. I prefer the more natural look of immersed specimens, but others like the sharpness of dry surfaces. If you do shoot specimens dry, be sure to sop as much moisture off the surface as possible. Otherwise, distracting highlights will ruin the picture.

specimen
image, endometriosis

Both photos were taken with a Nikon D100 digital SLR camera through a Sigma 50mm macro lens. The camera was set for manual focus, incandescent light balance, and aperture priority exposure mode at f/8. Both shots looked a little dark on the computer monitor, so I expanded the dynamic range in Photoshop using the Levels command. The only other digital editing was slight cropping of the top photo and downsampling to proper size (650 pixels, greatest linear dimension) for screen display. There was no sharpening or color correction. The imaged was saved in JPEG format with the quality setting "8 (High)". The black background is a piece of velvet.

Photograph by Ed Uthman, MD. Public domain. Posted 22 May 04


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