{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:33:44Z","timestamp":1793144024694,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cytopathology"],"published-print":{"date-parts":[[2026,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n Formalin\u2010fixed, paraffin\u2010embedded (FFPE) cell blocks (CBs) are widely used for processing cytology specimens, but preparation methods remain variable and non\u2010standardised. Low cellularity is a common limitation that may compromise diagnostic utility. This study aimed to evaluate the cellularity of routinely prepared CBs across different preparation methods, laboratories and sample types.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Each laboratory in this multicentre observational study retrospectively assessed 50 consecutive CBs prepared using a single method. Cellularity of Haematoxylin and Eosin (H&E)\u2010stained sections was semi\u2010quantitatively evaluated by two independent reviewers per laboratory in four categories: acellular, low (\u2264\u2009100 cells), medium (100\u2013500 cells) and high cellular (>\u2009500 cells). The proportion of poorly cellular CBs (acellular\u2009+\u2009low cellular) was compared across methods, laboratories and sample types using non\u2010parametric tests.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Cellularity was assessed for 1817 CBs prepared using Agar (22%), HistoGel (19%), Plasma\u2010Thrombin (19%), Cellient (17%), In\u2010house (15%) and Shandon\/Epredia (8%) methods. The proportion of poorly cellular CBs ranged from 4% to 80% across laboratories (mean 27%, median 25%), with no consistent clustering by method. Median proportions by method ranged from 12% (Cellient) to 35% (Agar), but inter\u2010method differences were not statistically significant (\n p<\/jats:italic>\n \u2009>\u20090.05). Substantial variability was observed both across and within sample types and preparation methods.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The study revealed marked variability in the proportion of poorly cellular CBs among preparation methods and laboratories, highlighting the need for improved processing and monitoring of CB adequacy.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/cyt.70065","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T15:16:50Z","timestamp":1772983010000},"page":"214-221","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cellularity of Routinely Prepared Cell Blocks: Insights From an International Study"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0934-0469","authenticated-orcid":false,"given":"Irena Srebotnik","family":"Kirbis","sequence":"first","affiliation":[{"name":"Institute of Pathology, Faculty of Medicine University of Ljubljana Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4089-0450","authenticated-orcid":false,"given":"Ivana","family":"Kholova","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University Tampere Finland"},{"name":"Department of Pathology, Fimlab Laboratories Tampere University Hospital Tampere Finland"},{"name":"Institute of Clinical Medicine, Pathology, and Forensic Medicine University of Eastern Finland Kuopio Finland"},{"name":"Department of Clinical Pathology, Diagnostic Imaging Centre Kuopio University Hospital Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1372-430X","authenticated-orcid":false,"given":"Heini","family":"Huhtala","sequence":"additional","affiliation":[{"name":"Faculty of Social Sciences Tampere University Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margareta Strojan","family":"Flezar","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Faculty of Medicine University of Ljubljana Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2368-4516","authenticated-orcid":false,"given":"Ruben Rodrigues","family":"Roque","sequence":"additional","affiliation":[{"name":"Anatomic Pathology Department Portuguese Institute of Oncology Francisco Gentil Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heli\u2010Hakso","family":"M\u00e4kinen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Fimlab Laboratories Tampere University Hospital Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miisa","family":"Litmanen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Fimlab Laboratories Tampere University Hospital Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danijela","family":"Vrdoljak\u2010Mozeti\u010d","sequence":"additional","affiliation":[{"name":"Department of Pathology and Cytology Clinical Hospital Centre Rijeka Rijeka Croatia"},{"name":"Department of Pathology, Medical Faculty University of Rijeka Rijeka Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6791-5289","authenticated-orcid":false,"given":"Suzana","family":"Harabajsa","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Cytology, Department of Pathology and Cytology University Hospital Centre Zagreb Zagreb Croatia"},{"name":"University of Applied Health Sciences Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekkehard","family":"Hewer","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Institute of Pathology Lausanne University Hospital and University of Lausanne Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrica","family":"Bresaola","sequence":"additional","affiliation":[{"name":"Cytology Unit, Department of Pathology European Institute of Oncology (IEO) Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lia","family":"Van Zuylen\u2010Manders","sequence":"additional","affiliation":[{"name":"Department of Pathology Radboudumc Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawel","family":"Schubert","sequence":"additional","affiliation":[{"name":"Division Anatomical Pathology, Department of Pathology National Health Laboratory Service, Tygerberg Hospital Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Pra\u00e7a","sequence":"additional","affiliation":[{"name":"Anatomic Pathology Service Gaia and Espinho Local Health Unit Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3819-4229","authenticated-orcid":false,"given":"Esther Diana","family":"Rossi","sequence":"additional","affiliation":[{"name":"Division of Anatomic Pathology and Histology\u2010Fondazione Policlinico Universitario \u2018Agostino Gemelli\u2019\u2010IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9633-4042","authenticated-orcid":false,"given":"Peter Karl","family":"Bode","sequence":"additional","affiliation":[{"name":"Institute of Pathology Cantonal Hospital Winterthur Winterthur Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laetitia","family":"Lacoste\u2010Collin","sequence":"additional","affiliation":[{"name":"MEDIPATH Toulouse Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Barizzi","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Ente Ospedaliero Cantonale Locarno Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1132-1761","authenticated-orcid":false,"given":"Vincenzo","family":"Fiorentino","sequence":"additional","affiliation":[{"name":"Department of Human Pathology in Adult and Developmental Age \u2018Gaetano Barresi\u2019 University of Messina Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Hedegaard","sequence":"additional","affiliation":[{"name":"Department of Histopathology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sietske","family":"van der Meulen","sequence":"additional","affiliation":[{"name":"Department of Pathology Treant Hoogeveen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ute","family":"Engel","sequence":"additional","affiliation":[{"name":"Clinical Pathology and Cytology Department District Hospital J\u00f6nk\u00f6ping J\u00f6nk\u00f6pin Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Timmer","sequence":"additional","affiliation":[{"name":"Department of Cytology Pathology OLVG Lab bv Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tugba Taskin","family":"Turkmenoglu","sequence":"additional","affiliation":[{"name":"Department of Pathology Ankara Etlik City Hospital Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jadranka","family":"Vidak","sequence":"additional","affiliation":[{"name":"Cytopathology, Cellular Pathology, North West London Pathology Hosted by Imperial College Healthcare NHS Trust London 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Laboratory Medicine Loyola University Healthcare System Maywood Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6796-9380","authenticated-orcid":false,"given":"Mar\u00eda D.","family":"Lozano","sequence":"additional","affiliation":[{"name":"Department of Pathology Clinica University of Navarra Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ljube","family":"Ivkovski","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Cytology Histolab Laboratories Skopje North Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettien","family":"van Hemel","sequence":"additional","affiliation":[{"name":"Department of Pathology Univesity Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Carsana","sequence":"additional","affiliation":[{"name":"Pathology Unit, ASST 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