Pyopneumothorax is a common complication associated with tuberculosis, especially in patients with lung parenchymal cavitatory lesions. In this publication, we highlight the case of a 43-year-old female patient who presented with chief complaints of dry cough, left-sided chest pain, and dyspnea on exertion. An X-ray of the chest posteroanterior (PA) view, revealed a left-sided moderate pleural effusion with pneumothorax. Immediate intercostal chest drain (ICD) insertion was done and a pleural fluid cytology sample was sent which was suggestive of tubercular empyema and the patient was promptly initiated on anti-tubercular treatment to which she responded well and showed clinical and radiological improvements.

Tuberculosis (TB) and cancer are two of the most prevalent disease across the globe. Cases of lung cancer are increasing rapidly and have now reached almost epidemic levels throughout the world. The two diseases share various radiological features and symptoms and coming to a diagnosis sometimes becomes challenging. In a situation like this, an invasive procedure to establish a diagnosis becomes necessary. We report a case of 35-year-old female presenting with cough and dyspnea, initially diagnosed as pulmonary bronchopneumonia and later found to have alveolar-cell carcinoma.