A 67-year-old male was admitted to the Surgical Outpatients Department of The First Affiliated Hospital of Soochow University (Suzhou, China), with a mass lesion (2x2 cm) on the right lung (Fig. 1). The lesion was detected during a routine medical examination. A video-assisted thoracoscopic lobectomy was performed to remove the mass, and histopathological examination revealed a lung adenocarcinoma with visceral pleural invasion. The patient underwent four courses of adjuvant chemotherapy (75 mg/m2 cisplatin and 100 mg/m2 gemcitabine) and was clinically diagnosed as disease free. However, the appearance of multiple patchy shadows on the right lung was observed in CT scans at 32 months following the surgery. The patient did not present any evident changes in the chest radiographs and serum tumor marker tests during the subsequent nine-month follow-up period. After the nine-month period, chest CT scans revealed a subpleural nodule (0.5x0.5 cm) and a slight enlargement of the patchy shadow on the right lung (Fig. 2). PET-CT scans revealed that the FDG uptake of the nodule had a SUVmax of 6.1. A that indicated malignant disease. A video-assisted thoracoscopic biopsy indicated that the patient suffered from tuberculosis (Fig. 3). Written informed consent was obtained from the patient.