Salivary glands


Necrotizing sialometaplasia

Last author update: 1 October 2015
Last staff update: 7 October 2022

Copyright: 2002-2023,, Inc.

PubMed Search: Necrotizing sialometaplasia[TI] salivary glands

Sally Tanakchi, M.D.
F. Zahra Aly, M.D., Ph.D.
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Cite this page: Tanakchi S, Aly FZ. Necrotizing sialometaplasia. website. 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
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)
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Metaplasia of residual salivary ducts

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Outlines of salivary acini

Images hosted on other servers:
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Necrosis and normal gland

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Squamous metaplasia

Positive stains
Board review style question #1
Which of the following sites is most commonly involved in necrotizing sialometaplasia?

  1. Dorsal tongue
  2. Palate
  3. Retromolar trigone
  4. 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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