Silicosis is fibrosing disease of the lungs caused by inhalation, retention and pulmonary reaction to crystalline silica which contain silicon dioxide. The risk of developing pulmonary tuberculosis is reported to be 2.8 to 39–fold higher for patients with silicosis than for healthy controls. The incidence of tuberculosis in silicosis is 28.6% in India. Out of extra pulmonary tuberculosis pleural form is most common, accounting for 61% of the cases, followed by the pericardial and least lymph node involvement. Regarding the relationship between mycobacterium–related diseases and different forms of silicosis, studies in the international literature have shown that the acute and accelerated forms present with the highest incidence. In our case report, patient has chronic history of silica exposure of more than 30 years, thus presenting as a case of chronic silicosis but the patient’s presenting X– Ray picture was suggestive of a concomitant mass like lesion.