Clinical presentation: A 60-year-old woman was referred for evaluation of a hypothyroidism and nodular goiter have been known for a decade.

Palpation. No abnormality.

Laboratory tests: TSH 1.08 mIU/L, aTPO 92 U/mL on daily 87.5 microgram levothyroxine.

Ultrasonography. The thyroid was minimally-moderately hypoechogenic. There was a more inhomogeneous, echonormal discrete area in the medial part of the right lobe. Compared with the first examination, the discrete lesion has increased by more than 60% in volume.

Aspiration cytology: Hashimoto's thyroiditis.

Comment. It is ambiguous as to whether this lesion is a nodule in pathological sense or not.