Clinical presentation: A 33-year-old man was referred for evaluation of a minimally elevated TSH-level detected on routine blood test. He had no complaints.

Palpation: Both lobes were firm on palpation.

Functional state: TSH 4.18 mIU/L, FT4 18.2 pM/L, aTPO 894 U/mL.

Ultrasonography: The thyroid presented the so-called honey-combing pattern: connective tissue septum divided the hypoechogenic thyroid into smaller areas.

Diagnosis: Hashimoto's thyroiditis.

We offered yearly TSH-determination.

Comment. It is to be avoided to overrate the relatively larger hypoechogenic areas as nodules.