Slootweg P J, Müller H
Pathology Instítute, University of Utrecht, The Netherlands.
J Craniomaxillofac Surg. 1990 Jul;18(5):210-4. doi: 10.1016/s1010-5182(05)80413-5.
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.
对30例颌骨纤维-骨病变进行了评估，以确定有助于进行恰当诊断分类的组织学参数。特别强调了病变-颌骨界面的组织形态学，病变骨与相邻颌骨的融合情况被用作区分纤维发育不良和其他颌骨纤维-骨病变的决定性因素。利用这一特征作为鉴别工具，可以确定其他有助于鉴别诊断的组织学方面。纤维发育不良（n = 11）表现出相当一致的外观，在整个病变中骨与纤维组织的比例恒定；几乎不存在无细胞矿化颗粒。青少年骨化性纤维瘤（n = 3）的特征是具有高度细胞性的成纤维细胞基质和花环样的细胞类骨质束。骨化性纤维瘤（n = 12）在基质细胞性和矿化物质类型方面表现出高度变异性。局限性根尖周纤维-骨牙骨质病变（n = 4）在组织学上几乎与骨化性纤维瘤相似，尽管矿化程度更高。得出的结论是，在判断颌骨纤维-骨病变是否有界限或与周围组织融合方面，组织学和放射学完全一致。此外，基于组织学依据可以可靠地做出恰当诊断。
