Clinical presentation: A 30-year-old woman requested evaluation of vague neck complaints, mainly 'lump in the throat feeling'.

Palpation: The right lobe was suspicious having a firm lesion.

Result of blood test: TSH 2.00 mIU/L, FT4 10.7 pM/L, aTPO 10.5 U/mL, calcitonin <2 pg/ml (normal value <5).

Ultrasonography. The thyroid was echonormal. There was a hypoechoic nodule in the right lobe. The lesion had lobulated margins and presented microcalcifications. The vascularity was non-specific.

We performed aspiration cytological examination on two different occasions, both resulted in Bethesda III (AUS) category because of the presence of atypical cell groups showing nuclear crowding and because of the presence of grooves.

We gave a common ultrasound-cytological diagnosis of suspicion of papillary cancer.

Histopathology disclosed papillary cancer.

Comment. The cytological pattern fulfilled the criteria of Bethesda III category. By definition, it means an around 15% risk of cancer. This patient surely had greater risk on the ultrasound presentation.