There was a 19% increase in year 2021 when compared to 2020 in TB patients’ notification in India, even though TB notifications noted around the period corresponding to India’s two major COVID-19 waves showed a brief decline, the National Tuberculosis Elimination Programme (NTEP) managed to reclaim the lost numbers. Cystic changes of the soft tissue and chest wall associated with pulmonary tuberculosis is rarely diagnosed and reported, and only few patients were diagnosed based only on the radiological and histopathological findings. Herewith, we report the microbiological, histopathological, computed tomographic, ultrasound and clinical findings of cystic change in pulmonary tuberculosis in an immunocompetent 18-year-old male who presented with pain in the Chest and swelling in the left infra mammary region for a short duration of one month. The lesion regressed and patient showed clinical improvement following Anti-tuberculous therapy treatment initiation after linking the patient with NIKSHAY system and is currently under ATT.