TIRADS - case 1281 (ultrasonographic picture 3)

Right lobe, another longitudinal. The nodule is composed of parts with different echogenicities. Both the brighter and darker areas of the lesion are more echogenic compared to the extranodular tissue. Therefore, the nodule should be regarded as iso/hyperechoic if the reference is the extranodular part. However, if the reference would be the healthy thyroid, then the dorsal, minority part is echonormal while the other parts are minimally/moderately hypoechoic, therefore the nodule should be classified as a dominantly minimally/hypoechoic heterogeneous nodule.