Oral cavity & oropharynx

Inflammatory / immune mediated (noninfectious)

Median rhomboid glossitis

Last author update: 1 February 2013
Last staff update: 4 August 2021

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PubMed Search: Glossitis[TI] oral cavity

Charu Thakral, M.D.
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Cite this page: Thakral C. Median rhomboid glossitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/oralcavityglossitis.html. Accessed August 15th, 2022.
Definition / general
  • Inflammation or beefy red tongue associated with deficiency states
  • Due to atrophy of tongue papillae, thinning of mucosa and exposure of underlying vasculature
  • Also called central papillary atrophy, posterior lingual papillary atrophy
  • 1% population, usually males, ages 30 - 50 years
Clinical features
  • Usually a clinical diagnosis
  • Causes: pernicious anemia (vitamin B12 deficiency), deficiency of riboflavin, niacin or pyridoxine; sprue, iron deficiency anemia; also associated with jagged teeth, ill fitting dentures, rarely syphilis, burns and ingestion of corrosive chemicals
  • Susceptible to recurring or chronic atrophic candidiasis
  • Plummer-Vinson / Paterson-Kelly syndrome: iron deficiency anemia, glossitis and esophageal webs
  • Median rhomboid glossitis: red patch, usually 2 - 3 cm long, in posterior midline dorsal tongue just anterior to V shaped grouping of circumvallate papillae with loss of papillae or taste buds; associated with candidiasis and diabetes mellitus (Eur J Dent 2011;5:367)
  • Usually none
  • Antifungal therapy to reduce clinical erythema of candidiasis
Clinical images

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Median rhomboid glossitis

Diabetic patient

Microscopic (histologic) description
  • Atrophic stratified squamous epithelium overlying moderately fibrosed stroma with chronic inflammation
  • Also chronic candida infection with associated pseudoepitheliomatous hyperplasia
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