Publication: Müllerianosis
Authors
Batt, R.E ; Smith, R.A. ; Buck Louis, G.M. ; Martin, D.C. ; Chapron, C. ; Koninckx, P.R. ; Yeh, J.
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
Müllerianosis may be defined as an organoid
structure of embryonic origin; a choristoma composed of
müllerian rests - normal endometrium, normal
endosalpinx, and normal endocervix - singly or in
combination, incorporated within other normal organs
during organogenesis. A choristoma is a mass of
histologically normal tissue that is “not normally found
in the organ or structure in which it is located”
(Choristoma, 2006). Müllerian choristomas are a subset
of non-müllerian choristomas found throughout the
body.
Histologically, endometrial-müllerianosis and
endometriosis are both composed of endometrial glands
and stroma, but there the similarity ends. Their
pathogenesis is different. Sampson faced the same
difficulty with pathogenesis and nomenclature when he
wrote: “The nomenclature of misplaced endometrial or
müllerian lesions is a difficult one to decide upon.” “The
term müllerian would be inclusive and correct, but
unfortunately it suggests an embryonic origin.” Sampson
then divided “misplaced endometrial or müllerian tissue”
into “four or possibly five groups, according to the
manner in which this tissue reached its ectopic location”
(Sampson, 1925).
Sampson’s classification of heterotopic or misplaced
endometrial tissue is based on pathogenesis: 1) “direct or
primary endometriosis” [adenomyosis]; “a similar
condition occurs in the wall of the tube from its invasion
by the tubal mucosa” [endosalpingiosis]; 2) “peritoneal
or implantation endometriosis;” 3) “transplantation
endometriosis;” 4) “metastatic endometriosis;” and 5)
“developmentally misplaced endometrial tissue. (I admit
the possibility of such a condition, but have never been
able to appreciate it.)” (Sampson, 1925). It is precisely
this condition “developmentally misplaced endometrial
tissue,” [müllerianosis] that is the subject of this review.
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