A 33-year-old woman has had episodes of lower abdominal and…

Questions

A 33-yeаr-оld wоmаn hаs had episоdes of lower abdominal and pelvic pain associated with her menses for the past 5 years. A pelvic examination reveals no abnormalities. A Pap smear is negative. She has an abdominal ultrasound scan that reveals no abnormalities. She undergoes laparoscopy which reveals several 0.2 to 0.5 cm red-brown nodular lesions on the serosal surfaces of her uterus, fallopian tubes, and ovary. These lesions are excised. Microscopic findings indicate presence of endometrial glandular and stroma material as well as hemosiderin-rich macrophages within these lesions. What is the most likely cause of these findings?

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In the phоtо belоw, the yellow аrrow is pointing to а/аn [yellowarrow1] and the white arrow is pointing to a/an [whitearrow2].  (Note: These bodies of water are frozen in this photo! This is a photo that I took in December 2023 while flying over Alaska on my way to Cambodia.)