Clinical presentation: A 65-yr-old woman was referred for evaluation of a nodular goiter, which has been found on routine physical examination.

Palpation: an elastic nodule in the right lobe.

Laboratory test: TSH 3.07 mIU/L.

Ultrasonography. The thyroid was echonormal. There was a cystic nodule with a moderately hypoechoic solid part in the right lobe. While the borders were regular before the aspiration, these became lobular after the removal of 3 mL cystic fluid.

Cytology resulted in benign lesion.

Comments.

1. The connective tissue running on the ventral surface of the thyroid has been broken which raises the possibility of extrathyroidal spread.

2. The borders were blurred at some parts of the ventral surface of the nodule. However, this was caused by a shadow running from the most ventral part. The cause for this shadow was the improper fitting of the transducer to the neck of the patient. So, this blur was of non-pathological origin.

3. After the aspiration, the borders of the nodule became lobular. But this is not a pathological form of lobulation.