Clinical presentation: A 45-year-old woman was examined because of weight gain. On ultrasound Hashimoto's thyroiditis and multiple hypoechogenic nodules were described.

Palpation: The right lobe was firm on palpation.

Laboratory tests: TSH 4.08 mIU/L, aTPO 708 U/mL.

Ultrasound. The right lobe and the isthmus had multiple discrete hypoechogenic areas within an echonormal background. The echogenicity index was above 70% in the right lobe. The discrete lesions had partly blurred, partly puzzle-like borders. The entire left lobe was hypoechogenic.

Aspiration cytology from a hypoechogenic lesion resulted in Hashimoto's thyroiditis.

Comment. The lesions presented in this case are very likely not nodules in pathological sense.