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Abstract We report a case of a 28‐year‐old immunocompetent woman found to have a mediastinal lesion on chest x‐ray performed as part of a visa renewal process. Computed tomographic imaging revealed a cystic superior anterior mediastinal mass. Although initially asymptomatic, the woman subsequently developed progressive chest discomfort. She underwent surgical resection of the mass. Histological assessment demonstrated necrotizing granulomatous inflammation, while Gene Xpert™ testing was positive for Mycobacterium tuberculosis complex and she was subsequently commenced on anti‐tuberculous therapy.