Waffle diagnosis
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A waffle diagnosis 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.[1]
Points to remember
- These diagnoses essentially say "I don't know"/"I cannot call it benign & I cannot call it suspicious".
- 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.
- 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 cell of unknown significance (ASCUS) - gynecologic cytopathology.
- Follicular lesion of unknown significance (FLUS) - thyroid cytopathology.
Surgical pathology
- Atypical small acinar proliferation (ASAP) - prostate gland pathology.
- Indefinite for dysplasia - GI pathology.
- Papillary urothelial neoplasm of low malignant potential (PUNLMP) - GU pathology.
- Smooth muscle tumour of uncertain malignant potential (STUMP) - Gynecologic pathology.
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.