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Rheumatoid arthritis (RA) is an autoimmune disorder of unknown aetiology that characteristically causes progressive, symmetric erosive destruction of bone and cartilage which can lead to deformities that may be often debilitating. Although joint involvement is the primary manifestation of rheumatoid arthritis, there have been many instances where it can primarily present with extra-articular manifestation in the form of subcutaneous nodule formation, vasculitis, inflammatory changes in the eyes, pericardial involvement and lung involvement. Involvement of respiratory system may be seen in 30-40% patients of rheumatoid arthritis and in 10% of the patients, involvement of the respiratory system may be the initial manifestation and may precede the articular manifestations. It may present in the form of parenchymal involvement manifesting as interstitial lung disease, airway abnormality or with pleural involvement presenting as pleural effusion and rarely may present as pulmonary vasculitis. We present a rare case of 60-year-old man presenting with pulmonary vasculitis in the form cavitating nodule with effusion with high levels of anti-cyclic citrullinated peptide (anti CCP) and RA levels.