Clinical presentation: A 59-year-old woman was referred for aspiration cytology of a nodule detected on evaluation of weight gain. A multinodular goiter was described including suspicious nodules because of increased vascularization.

Palpation: The right lobe was firm.

Laboratory tests: TSH 4.01 mIU/L, aTPO 4 U/mL.

Ultrasound. The thyroid contained numerous smaller and larger hypoechogenic areas. These areas had irregular shape and puzzle-like borders. The largest lesion in the right lobe presented increased vascularization.

Aspiration cytology from the hypoechogenic lesion in the right lobe resulted in Hashimoto's thyroiditis.

Comment. The lesions are unlikely being nodules in pathological sense.