Differential diagnosis of fibro-osseous jaw lesions. A histological investigation on 30 cases

J Craniomaxillofac Surg. 1990 Jul;18(5):210-4. doi: 10.1016/s1010-5182(05)80413-5.

Abstract

A series of 30 fibro-osseous jaw lesions was evaluated for histological parameters that enable appropriate diagnostic classification. Special emphasis was laid upon the histomorphology of the lesion-jawbone interface, blending of lesional bone with adjacent jawbone being employed as the decisive factor in distinguishing between fibrous dysplasia and other fibro-osseous jaw lesions. Using this feature as a discriminative tool, other histological aspects that were useful in differential diagnosis could be identified. Fibrous dysplasia (n = 11) shows a rather uniform appearance with a constant ratio bone: fibrous tissue throughout the entire lesion; acellular mineralized particles are virtually absent. Juvenile ossifying fibroma (n = 3) is characterized by a highly cellular fibroblastic stroma and garland-like strands of cellular osteoid. Ossifying fibroma (n = 12) shows a high variability in stromal cellularity and types of mineralized material. Localized periapical fibro-osseous cemental lesions (n = 4) are histologically almost similar to ossifying fibroma although more heavily mineralized. It is concluded that there is full agreement between histology and radiology in indicating whether a fibro-osseous jaw lesion is demarcated or blends into its surroundings. Moreover, an appropriate diagnosis can be reliably made on histological grounds.

MeSH terms

  • Adolescent
  • Adult
  • Cell Nucleus / ultrastructure
  • Child
  • Collagen
  • Diagnosis, Differential
  • Female
  • Fibroblasts / pathology
  • Fibroma / diagnostic imaging
  • Fibroma / pathology
  • Fibrous Dysplasia of Bone / diagnostic imaging
  • Fibrous Dysplasia of Bone / pathology
  • Humans
  • Jaw / diagnostic imaging
  • Jaw / pathology
  • Jaw Diseases / diagnostic imaging
  • Jaw Diseases / pathology*
  • Male
  • Middle Aged
  • Osteoblasts / pathology
  • Osteoclasts / pathology
  • Osteoma / diagnostic imaging
  • Osteoma / pathology
  • Radiography

Substances

  • Collagen