Salivary glands
Necrotizing sialometaplasia

Author: Sally Tanakchi (see Authors page)
Editor: F. Zahra Aly, M.D., Ph.D.

Revised: 2 October 2018, last major update October 2015

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Necrotizing sialometaplasia[TI] salivary glands
Cite this page: Tanakchi, S. Necrotizing sialometaplasia. website. Accessed December 15th, 2018.
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

Images hosted on other servers:
Missing Image

Necrosis and normal gland

Missing Image

Squamous metaplasia

Missing Image

Pseudo-epitheliomatous hyperplasia

Missing Image

Palate biopsy

Missing Image Missing Image Missing Image

NSM versus SCC

Positive stains