A 66-year-old man was admitted to Municipal Kushiro General Hospital for examination of abnormal shadowing on chest X-ray film. The chest computed tomography showed multiple nodules in both lungs. We suspected a metastatic lung tumor and performed transbronchial lung biopsy several times. However, there was no evidence of malignancy. After that, the size of the nodules increased gradually. To obtain a diagnosis, surgical biopsy by video-assisted thoracoscopic surgery was performed. Pathological findings showed fibrinoid necrosis with surrounding palisading granuloma. During the follow-up period, arthralgia emerged with elevation of anti-cyclic citrullinated peptide antibody levels. We diagnosed him as having rheumatoid arthritis with pulmonary rheumatoid nodules. After bucillamine was prescribed, the size of the nodules enlarged. Therefore, a low dose of prednisolone was prescribed in addition to bucillamine, and the nodules decreased. This case suggests prednisolone was effective in the treatment of pulmonary rheumatoid nodules.