Infliximab therapy is associated with higher rates of active tuberculosis (TB), particularly extrapulmonary and disseminated forms with unusual symptoms. We report the case of a 66-year-old man with Crohn's disease who developed TB mimicking lung cancer on imaging. He presented with cough and fever of 2 weeks' duration shortly after starting infliximab. Computed tomography of the chest revealed a 7.0 × 3.2 cm