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This review defines müllerianosis as an organoid choristoma consisting of normal endometrial, tubal, or cervical rests incorporated into other organs during embryogenesis. The authors distinguish this condition from endometriosis by highlighting their different pathogeneses, noting that while both share histological features of endometrial glands and stroma, müllerianosis represents developmentally misplaced tissue rather than acquired ectopic implants. The paper explicitly focuses on Sampson’s classification of "developmentally misplaced endometrial tissue" to clarify the nomenclature and origin of these specific lesions. This paper is centrally about endometriosis — specifically, it provides a historical and pathological distinction between müllerianosis and endometriosis based on pathogenesis.
Abstract
Müllerianosis may be defined as an organoid\n\t\t\t\t structure of embryonic origin; a choristoma composed of\n\t\t\t\t müllerian rests - normal endometrium, normal\n\t\t\t\t endosalpinx, and normal endocervix - singly or in\n\t\t\t\t combination, incorporated within other normal organs\n\t\t\t\t during organogenesis. A choristoma is a mass of\n\t\t\t\t histologically normal tissue that is “not normally found\n\t\t\t\t in the organ or structure in which it is located”\n\t\t\t\t (Choristoma, 2006). Müllerian choristomas are a subset\n\t\t\t\t of non-müllerian choristomas found throughout the\n\t\t\t\t body.\n\t\t\t\t Histologically, endometrial-müllerianosis and\n\t\t\t\t endometriosis are both composed of endometrial glands\n\t\t\t\t and stroma, but there the similarity ends. Their\n\t\t\t\t pathogenesis is different. Sampson faced the same\n\t\t\t\t difficulty with pathogenesis and nomenclature when he\n\t\t\t\t wrote: “The nomenclature of misplaced endometrial or\n\t\t\t\t müllerian lesions is a difficult one to decide upon.” “The\n\t\t\t\t term müllerian would be inclusive and correct, but\n\t\t\t\t unfortunately it suggests an embryonic origin.” Sampson\n\t\t\t\t then divided “misplaced endometrial or müllerian tissue”\n\t\t\t\t into “four or possibly five groups, according to the\n\t\t\t\t manner in which this tissue reached its ectopic location”\n\t\t\t\t (Sampson, 1925).\n\t\t\t\t Sampson’s classification of heterotopic or misplaced\n\t\t\t\t endometrial tissue is based on pathogenesis: 1) “direct or\n\t\t\t\t primary endometriosis” [adenomyosis]; “a similar\n\t\t\t\t condition occurs in the wall of the tube from its invasion\n\t\t\t\t by the tubal mucosa” [endosalpingiosis]; 2) “peritoneal\n\t\t\t\t or implantation endometriosis;” 3) “transplantation\n\t\t\t\t endometriosis;” 4) “metastatic endometriosis;” and 5)\n\t\t\t\t “developmentally misplaced endometrial tissue. (I admit\n\t\t\t\t the possibility of such a condition, but have never been\n\t\t\t\t able to appreciate it.)” (Sampson, 1925). It is precisely\n\t\t\t\t this condition “developmentally misplaced endometrial\n\t\t\t\t tissue,” [müllerianosis] that is the subject of this review.
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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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Citation
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