Salivary glands
Necrotizing sialometaplasia

Topic Completed: 1 October 2015

Minor changes: 2 March 2020

Copyright: 2002-2020,, Inc.

PubMed Search: Necrotizing sialometaplasia[TI] salivary glands

Sally Tanakchi, M.D.
F. Zahra Aly, M.D., Ph.D.
Page views in 2019: 4,158
Page views in 2020 to date: 2,838
Cite this page: Tanakchi S, Aly FZ. Necrotizing sialometaplasia. website. Accessed August 7th, 2020.
Definition / general
  • Reactive, self resolving condition, mostly affecting the palate
  • Heals within 6 - 10 weeks
  • Etiology is thought to be reaction to trauma or smoking in the presence of existing tissue ischemia
  • Mimics malignant diagnosis both clinically and histologically
  • Interestingly, has been reported in the context of bulemia
Case reports
Gross description
  • Crater-like ulcerated lesion of hard palate
Microscopic (histologic) description
  • Pseudoepitheliomatous hyperplasia
  • Squamous metaplasia of ducts and acini
  • Preservation of lobular architecture
  • Lobular infarction with or without mucin spillage
  • Inflammation secondary to extravasation of mucin
  • Conceptualized by 5 stages of development and evolution:
    • Infarction
    • Sequestration
    • Ulceration
    • Repair
    • Healing
Microscopic (histologic) images

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Necrosis and normal gland

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Squamous metaplasia

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Pseudo-epitheliomatous hyperplasia

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Palate biopsy

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NSM versus SCC

Positive stains
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