Aspergilloma is a non-invasive form of pulmonary aspergillosis usually presenting as a clump of mold in pre-existing cavitary lung disease. Aspergillus related lung diseases have been classified into four types, whose manifestation is often related to previous lung diseases and host immunologic status. Cases of cavitary pulmonary aspergillosis without any evidence of pre-existing cavities, are rarely reported. We present here a case of pulmonary aspergillosis in which cavity formation appeared apparently after the establishment of infection. The occurrence of atypical presentations and the importance of recognizing these unusual cases of pulmonary aspergilloma is discussed.