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This 22 year old man complained of a lump in the jaw of recent onset. It was noticeably painful, especially to touch. Past medical history as well as routine physical exam and blood workup were within normal limits. Radiographically there was a well-delineated radiolucency associated with tooth #30. The periapical x-ray shows involvement of the mesial of tooth #31 as well as interadicular involvement of #30. At the time of surgery the buccal cortex was found to be intact. When exposed and palpated, the lesion was described as solid and rubbery.
 Although
the radiographs are suggestive of traumatic bone cyst due to the scalloped
borders, this was found to be a solid lesion thereby discounting the probability
of this diagnosis. Pain makes one think of a neurogenic lesion. The lack
of a hyperostotic border is a subtle finding, which might suggest that
the lesion may not be odontogenic.
Histology: Diagnosis: Neurofibroma
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Differential Diagnosis:
Slide 1 (medium power, H&E). This slide demonstrates fascicles of a wavy well-collagenized matrix containing cells with slender basophilic nuclei. Less cellular, myxoid areas are also noted.
Slide 2 (high power, H&E). A fibrillar wavy pattern is present as well as thin, serpentine nuclei.