Adenocarcinoma with Lymphogenic Spread
Imaging findings
A dominant part-solid nodule with associated smaller satellite nodules tracking along the bronchovascular bundle (a beaded appearance along the vein).
Key takeaways
While a dominant nodule with beaded satellite nodules is a classic presentation for histoplasmosis, the presence of a ground-glass component and the absence of lymphadenopathy should raise suspicion for malignancy (lymphogenic spread of tumor).
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