Clinical presentation: A 59-year-old woman underwent bilateral subtotal resection 9 years ago. Histopathology disclosed benign lesions. She was referred for aspiration cytology because of recurrent nodular goiter. The patient has noticed a hard lump in the left lobe for three years.

Palpation: hard small nodules in both thyroid beds.

Functional state: euthyroidism with TSH 3.01 mIU/L.

Ultrasonography. Both lobes were resected and contained several hypoechogenic lesions. There was a cystic nodule in the lower-ventral part of the right lobe. The structure of at least two lesions were typical of granulation around surgical thread: these were composed of a central echonormal area surrounded with a broad hypoechogenic rim. The echonormal part contained hyperechogenic granules. These lesions were irregularly shaped and avascular.

Aspiration cytology of the left lesion resulted in benign granulation around surgical thread.

Comment.

1. One lesion in the right and another one in the left lobe present typical feaures of a granulation around surgical thread.

2. The ultrasound presentation might be misleading for less-well experienced investigators because the pattern mimics that of a hypoechogenic nodule with microcalcifications.