Waffle diagnosis

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

It is usually used when a pathologist cannot decide whether something is benign or suspicious for malignant.

For some specimen types, it can be understood/used as a synonym for suspicious for malignancy.

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.

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.
• 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

• Diagnosis.
• Spot diagnosis.
• Non-small cell lung carcinoma.