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. 2021 Mar 30;11:7170. doi: 10.1038/s41598-021-85999-5

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© The Author(s) 2021

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Representative HRCT images of common cystic appearance alone or with co-existence of large cysts. (A) A 32-year-old female with S-LAM whose diagnosis was established by transbronchial lung biopsy (TBLB). Numerous pulmonary cysts are noted. (B) A 33-year-old female, clinically diagnosed as having S-LAM with moderate to severe cyst formation. (C) A 45-year-old female with S-LAM, diagnosed by lung biopsy, showed mild cyst formation. (D) A 39-year-old female with S-LAM, diagnosed by lung biopsy, showed very mild cyst formation. (E) A 39-year-old female with S-LAM. Cyst formation was very mild but included a large cyst. She had a history of right pneumothorax and LAM was diagnosed by lung biopsy. (F) A 38-year-old female with S-LAM. Large irregularly shaped cysts were observed in the right lung along with the pathognomonic cystic appearance. She had bilateral pneumothoraces simultaneously and the diagnosis was made histopathologically. (G) A 41-year-old female with S-LAM. Abnormality on chest roentgenogram was discovered at a regular health check-up and the diagnosis was made by lung biopsy. Several large cysts were seen in both lung fields. (H) A 71-year-old female with S-LAM. She had a right lower lobectomy due to lung cancer, but the co-existence of LAM in underlying lung tissue was not recognized. Large cysts were observed more frequently in the remaining right lung than the left lung.