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". | 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 | # 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> | ||
==Examples== | ==Examples== | ||
===Cytopathology=== | ===Cytopathology=== | ||
*Atypical squamous cells of | *[[Atypical squamous cells of undetermined significance]] (ASCUS) - [[gynecologic cytopathology]]. | ||
*Atypical glandular cells | *[[Atypical glandular cells]] (AGC) - [[gynecologic cytopathology]]. | ||
*Follicular lesion of | *[[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 - [[ | *[[Atypical intraductal proliferation]] - [[prostate gland]] pathology. | ||
*Smooth muscle tumour of uncertain malignant potential (STUMP) - [[ | *[[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
- These diagnoses essentially say "I don't know"/"I cannot call it benign & I cannot call it malignant".
- 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.
- The use of these diagnoses are often used as quality measures.
- Generally, they are not considered to have a distinct pathobiology.[2]
Examples
Cytopathology
- Atypical squamous cells of undetermined significance (ASCUS) - gynecologic cytopathology.
- Atypical glandular cells (AGC) - gynecologic cytopathology.
- Follicular lesion of undetermined significance (FLUS) - thyroid cytopathology.
Surgical pathology
- Atypical small acinar proliferation (ASAP) - prostate gland pathology.
- Atypical intraductal proliferation - prostate gland 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
References
- ↑ 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.
- ↑ 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.