Clinical presentation: A 35-year-old woman was referred for evaluation of a recurrent hyperthyroidism which has been diagnosed and treated for two months. The first onset of Graves' disease occurred five years ago.

Palpation. Both lobes were enlarged. No nodule was palpable.

Laboratory tests: TSH 7.34 mIU/L, FT4 3.31 pM/L on daily 30 mg methimazole.

Ultrasonography. The thyroid was moderately hypoechogenic and inhomogeneous and had multiple more hypoechogenic and less inhomogeneous discrete lesions which were not of regular geometrical shape and were not well demarcated. The vascularization was average.

Histopathology: Diffuse goiter without any nodules.

Comment. The irregular shape, the ill-defined borders and the multiplicity are those properties which stand against the possibility being any of the discrete lesions a nodule in pathological sense.