Mean lung density (dm) and radiologic (VLx) lung volume can be calculated using CT scan data. As many emphysematous patients are overdistended, the analysis of dm alone could be meaningless. However, lung mass (m) can be calculated as the product of dm and VLx. Twenty-four patients suspected of mild or severe emphysema as judged by roentgenographic and physiologic examinations as well as 16 healthy subjects were included in the protocol. They all underwent both a CT scan of the whole lung and functional tests from which the following were derived: airway resistance, forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), total lung capacity (TLC), CO transfer capacity, quasi-static compliance at functional residual capacity (FRC), and blood gases. All CT scans were performed at the FRC of each patient. The dm was lower in emphysema patients than in healthy subjects, as m was greater in patients than in healthy subjects; 1,303 +/- 398 g and 997 +/- 133 g, respectively. Although dm values were significantly correlated to FEV1, FEV1/FVC, and TLC, m values were not correlated to any of these functional indices. Unexpectedly, these results show that most patients (22/24) with emphysema have a normal or increased lung mass. Normal or above normal m values might be due to oversecretion in some patients. Nevertheless, the synthesis of new tissue due to chronic inflammation is the most likely explanation that could account for this finding.