A patient treated at our hospital with the diagnosis of smear positive pulmonary tuberculosis was rehospitalized six years later for hemoptysis. The chest x-ray showed a nearly homogenous opacity on the left upper zone. Computed tomography revealed a fungus ball in a cavity on the left upper lobe. The patient underwent left upper lobectomy because of the recurrent hemoptysis. Histopathologic diagnosis of the resected material was adenocarcinoma with the aspergilloma in the cavity on apicoposterior segment of the upper lobe. The case was presented for it demonstrated, in a patient with a background of tuberculosis, an adenocarcinoma which had developed on the wall of a cavity containing a fungus ball.