Waffle diagnosis

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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]



Surgical pathology

See also


  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.