Chest radiographs are an important tool for the diagnosis and follow-up. Yet the radiographic findings can vary significantly, ranging from the so-called usual to unusual patterns. In this paper the authors report three cases of pulmonary tuberculosis in which the chest radiographs showed a nodular, pseudo-tumoral pattern. Based on literature and on their own experience, the authors discuss the frequency of this radiologic presentation in this setting and its correlation with the immunological status of the patient, the pathogenicity of Mycobacterium tuberculosis and the clinical presentation of the disease.