**13. Histological confirmation**

Histologic confirmation is essential in the diagnosis of endometriosis. The utility of peritoneal wash cytology for diagnosis of endometriosis has been reported. In most cases, only hemosiderin-laden macrophages are identified. The presence of endometrial cells is more specific but less sensitive than hemosiderin-laden macrophages for the diagnosis of endometriosis. The endometrial cells have been reported in 25%–52% of peritoneal washes done in endometriosis. However, recognition of endometrial cells as well as hemosiderinladen macrophages is essential for diagnosis on morphological basis alone. Histologic examination of the tissue confirmed for endometriosis by the presence of both endometrioid glands and stroma (15).
