Clinical presentation: A 77-yr-old man was referred for aspiration cytology of a nodular goiter, which has been diagnosed on neck ultrasound examination.

Palpation: a not firm nodule in the right lobe.

Laboratory tests: TSH 0.18 mIU/L, FT4 20.6 pM/L, FT3 4.73 pM/L.

Ultrasonography. A large nodule occupied almost the entire right lobe. The nodule was heterogeneous: a central hypoechogenic area was surrounded with a thick echonormal rim. The borders between the different parts of the nodule were irregular, lobulated.

Cytology resulted in benign lesion.

Comment.

1. The term 'irregular margins' always refers to the outer surface of a nodule. Therefore, in this case the presence of irregularities between different parts of the nodule does not mean that the nodule has pathological lobulations or spiculations.
   
2. The lower parts of the nodule are blurred not because of pathology but this blur is only technical: in large nodules it is difficult to visualize properly the entire nodule.