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
- 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.