Salivary glands
Inflammation
Necrotizing sialometaplasia

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

Revised: 29 October 2015, last major update October 2015

Copyright: (c) 2002-2015, PathologyOutlines.com, Inc.

PubMed Search: Necrotizing sialometaplasia [title] salivary
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
Clinical Images
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Bilaterally ulcerated swellings of the palate

Gross Description
  • Crater-like ulcerated lesion of hard palate
Micro 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 five stages of development and evolution:
    • Infarction
    • Sequestration
    • Ulceration
    • Repair
    • Healing
Micro Images
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Various images

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Necrosis and normal gland

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Squamous metaplasia

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Pseudoepithe-
liomatous hyperplasia

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Palate biopsy

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NSM vs. SCC

Positive Stains