Guo T, Guo W, Song M, et al. - Five people diagnosed as pulmonary tuberculosis or tuberculous pleuritis received systematic anti-tuberculosis treatments in order to summarize and interpret the clinical manifestations, chest CT, laboratory findings, treatments, pathological biopsy outcomes of individuals diagnosed as a paradoxical reaction in the form of new pulmonary mass. When a new pulmonary mass occurs during anti-tuberculosis treatments, the paradoxical reaction was required to be acknowledged. The diagnosis should be on the basis of the peoples’ clinical manifestations, laboratory outcomes, imaging examinations, and lung biopsy examinations. Thus, the original anti-tuberculosis therapy could be sustained in people without critical clinical symptoms and a close follow-up is required.