Difference between revisions of "Waffle diagnosis"

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A '''waffle diagnosis''', also '''waffle category''', is something used to say "I don't know".  It is used when a pathologist cannot decide whether something is benign ''or'' suspicious for malignant.<ref name=pmid19373907>{{cite journal |author=Layfield LJ, Morton MJ, Cramer HM, Hirschowitz S |title=Implications of the proposed thyroid fine-needle aspiration category of "follicular lesion of undetermined significance": A five-year multi-institutional analysis |journal=Diagn. Cytopathol. |volume=37 |issue=10 |pages=710–4 |year=2009 |month=October |pmid=19373907 |doi=10.1002/dc.21093 |url=}}</ref>
A '''waffle diagnosis''', also '''waffle category''', is something used to say "I don't know"; it is a type of equivocation.   
 
In most cases it can be understood/used as a synonym for ''suspicious for malignancy''.
 
In some classifications, it may be used when the pathologist cannot decide whether something is benign ''or'' suspicious for malignant<ref name=pmid19373907>{{cite journal |author=Layfield LJ, Morton MJ, Cramer HM, Hirschowitz S |title=Implications of the proposed thyroid fine-needle aspiration category of "follicular lesion of undetermined significance": A five-year multi-institutional analysis |journal=Diagn. Cytopathol. |volume=37 |issue=10 |pages=710–4 |year=2009 |month=October |pmid=19373907 |doi=10.1002/dc.21093 |url=}}</ref> ''or'' dysplastic.
 


==Points to remember==
==Points to remember==
# These diagnoses essentially say "I don't know"/"I cannot call it benign & I cannot call it suspicious".
# These diagnoses essentially say "I don't know"/"I cannot call it benign & I cannot call it malignant".
# Their use should be minimized.
# Their use should be minimized.
#* The use of these diagnoses are often used as quality measures.
#* The use of these diagnoses are often used as [[quality]] measures.
#** Pathologists that use 'em too often aren't doing a good job.
#** Pathologists that use 'em too often aren't doing a good job.
#** Good pathologists use 'em when the findings are ambiguous after a diligent work-up.
# Generally, they are not considered to have a distinct pathobiology.<ref name=pmid17378841>{{cite journal |author=Flury SC, Galgano MT, Mills SE, Smolkin ME, Theodorescu D |title=Atypical small acinar proliferation: biopsy artefact or distinct pathological entity |journal=BJU International |volume=99 |issue=4 |pages=780-5 |year=2007 |month=January |pmid= 17378841 |doi= |url=http://www3.interscience.wiley.com/journal/118508438/abstract}}</ref>
# Generally, they are not considered to have a distinct pathobiology.<ref name=pmid17378841>{{cite journal |author=Flury SC, Galgano MT, Mills SE, Smolkin ME, Theodorescu D |title=Atypical small acinar proliferation: biopsy artefact or distinct pathological entity |journal=BJU International |volume=99 |issue=4 |pages=780-5 |year=2007 |month=January |pmid= 17378841 |doi= |url=http://www3.interscience.wiley.com/journal/118508438/abstract}}</ref>


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*[[Atypical squamous cells of undetermined significance]] (ASCUS) - [[gynecologic cytopathology]].
*[[Atypical squamous cells of undetermined significance]] (ASCUS) - [[gynecologic cytopathology]].
*[[Atypical glandular cells]] (AGC) - [[gynecologic cytopathology]].
*[[Atypical glandular cells]] (AGC) - [[gynecologic cytopathology]].
*Follicular lesion of unknown significance (FLUS) - [[thyroid cytopathology]].
*[[Follicular lesion of undetermined significance]] (FLUS) - [[thyroid cytopathology]].


===Surgical pathology===
===Surgical pathology===
*[[Atypical small acinar proliferation]] (ASAP) - [[prostate gland]] pathology.
*[[Atypical small acinar proliferation]] (ASAP) - [[prostate gland]] pathology.
*Indefinite for dysplasia - [[GI pathology]].
*[[Atypical intraductal proliferation]] - [[prostate gland]] pathology.
*[[Smooth muscle tumour of uncertain malignant potential]] (STUMP) - [[Gynecologic pathology]].
*[[Indefinite for dysplasia]] - [[gastrointestinal pathology]].
*[[Smooth muscle tumour of uncertain malignant potential]] (STUMP) - [[gynecologic pathology]].
*[[Prostatic stromal tumour of uncertain malignant potential]] (STUMP) - [[genitourinary pathology]]


==See also==
==See also==
*[[Diagnosis]].
*[[Diagnosis]].
*[[Spot diagnosis]].
*[[Spot diagnosis]].
*[[Non-small cell lung carcinoma]].


==References==
==References==

Latest revision as of 17:21, 3 April 2024

A waffle diagnosis, also waffle category, is something used to say "I don't know"; it is a type of equivocation.

In most cases it can be understood/used as a synonym for suspicious for malignancy.

In some classifications, it may be used when the pathologist cannot decide whether something is benign or suspicious for malignant[1] or dysplastic.


Points to remember

  1. These diagnoses essentially say "I don't know"/"I cannot call it benign & I cannot call it malignant".
  2. Their use should be minimized.
    • The use of these diagnoses are often used as quality measures.
      • Pathologists that use 'em too often aren't doing a good job.
      • Good pathologists use 'em when the findings are ambiguous after a diligent work-up.
  3. Generally, they are not considered to have a distinct pathobiology.[2]

Examples

Cytopathology

Surgical pathology

See also

References

  1. ↑ Layfield LJ, Morton MJ, Cramer HM, Hirschowitz S (October 2009). "Implications of the proposed thyroid fine-needle aspiration category of "follicular lesion of undetermined significance": A five-year multi-institutional analysis". Diagn. Cytopathol. 37 (10): 710–4. doi:10.1002/dc.21093. PMID 19373907.
  2. ↑ Flury SC, Galgano MT, Mills SE, Smolkin ME, Theodorescu D (January 2007). "Atypical small acinar proliferation: biopsy artefact or distinct pathological entity". BJU International 99 (4): 780-5. PMID 17378841. http://www3.interscience.wiley.com/journal/118508438/abstract.
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