Clinical presentation: A 71-yr-old woman was referred for follow-up of an autonomously functioning adenoma, which has been known for 17 years. The patient had 'lump in the throat feeling'.

Palpation: a large, not firm nodule in the right lobe.

Laboratory test: TSH 1.65 mIU/L, FT4 14.1 pM/L.

Ultrasonography. The right lobe had a large isoechoic nodule. Dorsal and lower to this lesion there was a hypoechoic nodule, which presented irregular, lobulated margins and taller-than-wide shape. The hypoechoic nodule presented irregularly increased intranodular vascularization.

Cytology of the hypoechoic lesion resulted in benign, colloid goiter.

Comment. The hypoechoic nodule had irregular, lobulated margins.