Diagnostic morphometry in emphysema and chronic bronchitis.

A morphometric technique of point counting was developed for macroscopic use in emphysematous lungs and microscopic use in bronchi to obtain actual areas and volumes, as opposed to ratios or percentages, of emphysema and submucosal glands. The results in emphysematous lungs showed that the volume of emphysema seen in one slice of one lung cannot be used to predict the volume in other slices, nor the volume of emphysema in one lung to predict the volume of emphysema in the other. The results in the airways showed that, if the volume of bronchial glands in each generation along an airway is expressed per unit of luminal surface area, a distinctive profile of gland distribution along the airway is obtained, as well as the mean volume per gland. These results are discussed in relation to the application of morphometry in individual cases for diagnostic purposes, revealing a need for a central repository of validated methods, so that each method is not repeatedly revalidated, and normal baseline data for the diagnostic morphometrist to use in deciding whether the findings in his or her individual patients are of diagnostic significance.