There is a hypoechogenic lesion in the upper ventral part of the right thyroid. There are several smaller similar hypoechogenic areas in the lobe, and the basic echostrucure is moderately hypoechogenic. Based on these findings, the probability of an underlying autoimmune thyroditis is more than 90% and around 70% in patients who are elder than and younger than 60 years, respectively. In spite of the presence of thyroiditis, the larger lesion may be a nodule. We can see echonormal lesions, too. These are surrounded with a halo sign.

To summarize: on ultrasound we cannot decide whether the hypoechogenic lesion is a nodule or only a pseudonodule, but the latter possibility seems to be more likely. Nevertheless, FNAC is required. This patient underwent surgery, the final histopathology disclosed Hashimoto's thyroiditis, and there wasn't any nodule in the thyroid.