Clinical presentation: A 62-yr-old woman was referred for evaluation of a nodular goiter detected on follow-up examination. The patient was operated on 17 years ago because of suspicious cytology. Histopathology disclosed Hashimoto's thyroiditis without any nodules.

Palpation: Both lobes were firm. The left lobe has an uneven surface.

Laboratory tests: TSH 4.27 mIU/L on daily 87.5 microgram levothyroxine.

Ultrasonography. The thyroid was moderately hypoechoic. There were numerous more echogenic islets within both lobes. The presence of pathological nodule was equivocal.

Cytology of a discrete lesion in the left lobe resulted in Hashimoto's thyroiditis.

Comment. The issue is whether discrete lesions in the left lobe are true nodules or not. The patient' history described above stands against this possibility.