Histologic Findings

The microscopic features of necrotizing sialometaplasia include coagulative necrosis of glandular acini and squamous metaplasia of its ducts. Mucin pooling is present, and an associated inflammatory infiltrate consists of macrophages; neutrophils; and, less commonly, lymphocytes, plasma cells, and eosinophils.

Pseudoepitheliomatous hyperplasia of the overlying mucosa can also be present, but the cytologic features of the squamous component are usually bland. Occasionally, isolated mucous cells may be entrapped within the squamous islands; these cells should not be confused with those of mucoepidermoid carcinoma.

The microscopic differential diagnosis for necrotizing sialometaplasia includes mucoepidermoid carcinoma and squamous cell carcinoma. Some believe that subacute necrotizing sialadenitis is yet another entity that occurs within the spectrum of necrotizing sialometaplasia; it should be distinguished from necrotizing sialometaplasia.

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Media Gallery

Initial presentation.
Three weeks later after biopsy.
At 6 weeks.
Nine weeks. Salivary gland infarction.

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Author

John A Svirsky, DDS, MEd Director of Oral Pathology Diagnostic Service, Professor of Oral and Maxillofacial Pathology, Virginia Commonwealth University School of Dentistry

John A Svirsky, DDS, MEd is a member of the following medical societies: American Academy of Oral and Maxillofacial Pathology, American Dental Association

Disclosure: Nothing to disclose.

Coauthor(s)

John E Fantasia, DDS Chief, Division of Oral Pathology, Department of Dermatology, Long Island Jewish Medical Center, North Shore-Long Island Jewish Health System

John E Fantasia, DDS is a member of the following medical societies: American Academy of Oral and Maxillofacial Pathology

Disclosure: Nothing to disclose.

Josephine Wu, DDS Assistant Director, Molecular Pathology Laboratory, Department of Pathology, Mount Sinai School of Medicine; Consulting Staff, Division of Oral and Maxillofacial Pathology, Department of Dental Medicine, Long Island Jewish Medical Center

Josephine Wu, DDS is a member of the following medical societies: American Academy of Oral and Maxillofacial Pathology, American Association for Cancer Research

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

Drore Eisen, MD, DDS Consulting Staff, Dermatology of Southwest Ohio

Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, American Dental Association

Disclosure: Nothing to disclose.

Chief Editor

Jeff Burgess, DDS, MSD (Retired) Clinical Assistant Professor, Department of Oral Medicine, University of Washington School of Dental Medicine; (Retired) Attending in Pain Center, University of Washington Medical Center; (Retired) Private Practice in Hawaii and Washington; Director, Oral Care Research Associates

Disclosure: Nothing to disclose.

Additional Contributors

Abdul-Ghani Kibbi, MD, FACP Professor and Chair, Department of Dermatology, American University of Beirut Medical Center, Lebanon

Disclosure: Nothing to disclose.

Necrotizing Sialometaplasia Workup

Histologic Findings

References

Tables

Contributor Information and Disclosures

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