Clinical presentation: A 33-year-old woman was referred for evaluation of hypothyroidism and suspected nodule detected on ultrasound.

Palpation. No abnormality.

Laboratory tests: TSH 1.31 mIU/L, aTPO 227 U/mL.

Ultrasonography. The thyroid was minimally hypoechogenic. The proliferation of connective tissue made a spider web-like appearance of the thyroid. Several discrete areas were found, none of them fit to a nodule in pathological sense.

Suggestion: TSH in a year.