Department of Pathology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Spain.
Best Pract Res Clin Obstet Gynaecol. 2011 Dec;25(6):705-18. doi: 10.1016/j.bpobgyn.2011.05.010. Epub 2011 Jul 13.
The term 'mixed Müllerian tumour' applies to uterine tumours composed of epithelial and mesenchymal elements of Müllerian origin. These neoplasms are classified into adenomyomas, adenofibromas, adenosarcomas, and carcinosarcomas (malignant Müllerian mixed tumours) based on whether the epithelial and stromal elements are benign or malignant. The rare atypical polypoid adenomyoma usually involves the lower uterine segment and, on curettings, may be confused with invasive adenocarcinoma. Adenosarcomas are low-grade neoplasms classified halfway along the spectrum of mixed Müllerian tumours, with adenofibromas at one end and carcinosarcomas (malignant Müllerian mixed tumours) at the other. Some tumours currently classified as 'adenofibromas' on the basis of their low mitotic count and lack of nuclear atypia are, in fact, well differentiated adenosarcomas. Carcinosarcoma is composed of admixed but distinctive carcinomatous and sarcomatous elements. On the basis of the clonal origin of both tumour components, carcinosarcomas are currently thought to be metaplastic carcinomas rather than uterine sarcomas.
“混合 Müllerian 肿瘤”一词适用于由 Müllerian 来源的上皮和间叶成分组成的子宫肿瘤。这些肿瘤根据上皮和基质成分是良性还是恶性，分为腺肌瘤、腺纤维瘤、腺肉瘤和癌肉瘤（恶性 Müllerian 混合瘤）。罕见的非典型息肉样腺肌瘤通常累及子宫下段，在刮宫时可能与浸润性腺癌混淆。腺肉瘤是低度恶性肿瘤，位于混合 Müllerian 肿瘤谱的中间位置，一端为腺纤维瘤，另一端为癌肉瘤（恶性 Müllerian 混合瘤）。一些目前基于低有丝分裂计数和缺乏核异型性而被归类为“腺纤维瘤”的肿瘤，实际上是分化良好的腺肉瘤。癌肉瘤由混合但独特的癌性和肉瘤性成分组成。基于两个肿瘤成分的克隆起源，癌肉瘤目前被认为是多形性癌而不是子宫肉瘤。
