Waffle diagnosis

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 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.

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

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