There are multiple discrete lesions within a near echonormal background. There are small differences in the ultrasound pattern of the nodule-like lesions.The more hypoechogenic areas (marked with red) contain non-specific hyperechogenic granules, while there are less hypoechogenic fields (marked with green). The former are more likely nodules in a pathological sense than the latter. The less well-defined areas marked with yellow are the ultrasound signs of the underlying thyroiditis.

To summerize: the presence of an underlying lymphocytic thyroiditis is very likely. We cannot be sure whether some discrete hypoechogenic areas are nodules in a pathological sense but this probability is more likely than the opposite. Cytology disclosed lymphocytic thyroiditis.