Clinical presentation: A 52-yr-old woman was referred for evaluation of a recently detected hypothyroidism.

Palpation: no abnormality.

Laboratory tests: TSH 12.6 mIU/L, aTPO 428 U/mL.

Ultrasonography. The thyroid was hypoechoic and presented several discrete lesions. The one which was located in the upper, ventrolateral part of the right lobe showed a heterogeneous pattern.

Suggestion: daily 75 microgram levothyroxine.

Comment. There was a discrete lesion in the ventro-lateral part of the right lobe. It seems more likely that this is not a real nodule, but a relatively intact part of the lobe that has not yet been completely infiltrated by inflammation.