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Published ahead of print on September 25, 2003, doi:10.1164/rccm.200308-1107OC
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American Journal of Respiratory and Critical Care Medicine Vol 169. pp. 120-124, (2004)
© 2004 American Thoracic Society

The Number of Alveoli in the Human Lung

Matthias Ochs, Jens R. Nyengaard, Anja Jung, Lars Knudsen, Marion Voigt, Thorsten Wahlers, Joachim Richter and Hans Jørgen G. Gundersen

Department of Anatomy, Division of Electron Microscopy, University of Göttingen, Göttingen; Department of Cardiothoracic and Vascular Surgery, University of Jena, Jena, Germany; Stereological Research Laboratory and Electron Microscopy Laboratory, University of Aarhus, Aarhus, Denmark; and California National Primate Research Center, University of California, Davis, California

Correspondence and requests for reprints should be addressed to Matthias Ochs, M.D., Division of Electron Microscopy, Department of Anatomy, Georg-August-University, Kreuzbergring 36, D-37075 Göttingen, Germany. E-mail: mochs{at}gwdg.de

The number of alveoli is a key structural determinant of lung architecture. A design-based stereologic approach was used for the direct and unbiased estimation of alveolar number in the human lung. The principle is based on two-dimensional topology in three-dimensional space and is free of assumptions on the shape, size, or spatial orientation of alveoli. Alveolar number is estimated by counting their openings at the level of the free septal edges, where they form a two-dimensional network. Mathematically, the Euler number of this network is estimated using physical disectors at a light microscopic level. In six adult human lungs, the mean alveolar number was 480 million (range: 274–790 million; coefficient of variation: 37%). Alveolar number was closely related to total lung volume, with larger lungs having considerably more alveoli. The mean size of a single alveolus was rather constant with 4.2 x 106µm3 (range: 3.3–4.8 x 106µm3; coefficient of variation: 10%), irrespective of the lung size. One cubic millimeter lung parenchyma would then contain around 170 alveoli. The method proved to be very efficient and easy to apply in practice. Future applications will show this approach to be an important addition to design-based stereologic methods for the quantitative analysis of lung structure.

Key Words: connectivity • disector • Euler number • morphometry • stereology




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