There are two hypoechogenic inhomogeneous lesions in the moderately hypoechogenic left thyroid. The larger one contains microcalcifications. The borders of these lesions are irregular and similar, smaller hypoechogenic areas are found dorsal to the larger lesion in longitudinal view.

To summarize: we cannot decide whether the largest lesion is a nodule or not on ultrasound. It is preferred not to use the term nodule in such cases but describe the dilemma on ultrasonographic report. Naturally, FNAC is mandatory from a lesion with such sonographic pattern. Cytology disclosed Hashimoto's thyroiditis.