Clinical presentation: A 37-year-old man was referred for evaluation of a nodular goiter which was detected on carotid Doppler examination. He has been treated for hypothyroidism for 5 years.

Palpation: no abnormality.

Functional state: TSH 4.16 mIU/L, aTPO < 28 U/ml, ahTG 0,9 U/l on daily 50 microgram levothyroxine.

Ultrasonography. The thyroid was minimally hypoechoic and inhomogeneous. There were two discrete lesions in the right lobe. The lower one had more hypoechoic areas.

Cytology was performed from the nodule in the lower part of the right lobe and resulted in lymphocytic thyroiditis.

Suggestion: daily 50 microgram levothyroxine, TSH in a year, ultrasound in five years.

Comment. These discrete lesions are probably not pathological nodules.