Abstract
A 68-year-old male with a known history of von Hippel-Lindau disease with brain hemangioblastoma status post radiation therapy and recurrent hemangioblastoma in the spine and multiple spinal surgeries presented initially to the emergency department due to hemoptysis and worsening shortness of breath. A CT chest demonstrated a left lung mass and left pleural effusion, which was initially suspected to be lung malignancy given his symptoms and history. However, it was determined to be a lung abscess following workup and consultations. This case highlights the similarities in the presentation of both pathologies and the critical features in lung abscesses.