CTICasesSubacute Histoplasmosis with Satellite Lymphatic Nodules
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Imaging findings
A young patient (20s-30s) presented with large subcarinal and right hilar lymphadenopathy and a dominant middle lobe nodule. Nodularity was observed along the bronchovascular bundle and draining vein, indicating lymphatic spread. The lesion was already partially calcified with some hypervascularity.
Key takeaways
This is a classic presentation of subacute histoplasmosis, characterized by robust lymphadenopathy often out of proportion to the lung nodule, and pathognomonic satellite lymphatic nodules around the original nidus. Rarely, coccidioidomycosis can present similarly. This pattern often allows for diagnosis without invasive procedures, as these lesions typically calcify, shrink, and regress over time.
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