**Core Concept**
Primary tuberculosis (TB) is the initial infection with Mycobacterium tuberculosis, usually occurring in the lungs. This infection is often asymptomatic, but it can present with a range of symptoms due to the body's immune response. The presentation of primary TB is influenced by the host's immune status, the virulence of the M. tuberculosis strain, and the presence of any underlying lung disease.

**Why the Correct Answer is Right**
The correct answer is related to the concept that primary TB often presents with a Ghon complex, which is a characteristic pathological finding. A Ghon complex consists of a primary focus of infection in the lung, usually in the upper lobe, along with associated lymphadenopathy in the hilar region. This presentation is due to the body's immune response to the M. tuberculosis infection, which leads to the formation of a granuloma in the lung tissue. The Ghon complex is a hallmark of primary TB and is often seen on chest radiographs.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not accurately describe the typical presentation of primary TB.
**Option B:** This option is incorrect because it is more characteristic of post-primary TB, which occurs when a person who has previously been infected with TB becomes re-infected with a different strain of the bacteria.
**Option C:** This option is incorrect because it does not accurately describe the typical presentation of primary TB.

**Clinical Pearl / High-Yield Fact**
A Ghon complex is often seen on chest radiographs as a small, well-defined nodule in the lung, accompanied by enlarged hilar lymph nodes. This is a classic radiographic finding of primary TB and should be considered in the differential diagnosis of any patient presenting with symptoms of TB.

**Correct Answer: D.**