Salivary glands
Inflammatory
Necrotizing sialometaplasia
Last author update: 1 October 2015
Last staff update: 7 October 2022
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PubMed Search: Necrotizing sialometaplasia[TI] salivary glands
Table of Contents
Definition / general | Case reports | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Differential diagnosis | Additional references | Board review style question #1 | Board review style answer #1Cite this page: Tanakchi S, Aly FZ. Necrotizing sialometaplasia. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/salivaryglandsnecrotizingsialo.html. Accessed September 22nd, 2023.
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
- 21 year old woman with one week history of bilateral painful swelling of palate (Med Oral Patol Oral Cir Bucal 2011;16:e700)
- 26 year old man with necrotizing sialometaplasia of palate (Case Rep Pathol 2012;2012:679325)
- 28 year old woman with palate ulcer, which was biopsied (Case of the Week #497)
- 35 year old man with necrotizing sialometaplasia (J Oral Maxillofac Pathol 2014;18:420)
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
Contributed by Dr. Kelly Magliocca (Case #497)
Metaplasia of residual salivary ducts
Outlines of salivary acini
Images hosted on other servers:
Necrosis and normal gland
Squamous metaplasia
Differential diagnosis
Additional references
Board review style question #1
Which of the following sites is most commonly involved in necrotizing sialometaplasia?
- Dorsal tongue
- Palate
- Retromolar trigone
- Submandibular gland
Board review style answer #1
B. The palate is most commonly involved among the anatomic sites listed.
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Reference: Necrotizing sialometaplasia
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Reference: Necrotizing sialometaplasia
