There is a large hypoechogenic lesion with microcalcifications in the isthmic part of the thyroid. The basic echostructure of the lesion differs from that of the extralesional part. It favours the possibility that it is a nodule. The blurred borders and the presence of the microcalcifications raise the possibility of papillary cancer. However, the basic, moderately hypoechogenic structure of the thyroid is a very specific sign of lymphocytic thyroiditis. Less and more hypoechogenic areas are frequent findings in thyroiditis as are the blurred borders of discrete areas. Taking every features into account, this lesion might be a nodule with great but not all probability, and the performance of aspiration cytology is mandatory.

This patient underwent surgery, the final histopathology disclosed Hashimoto's thyroiditis, and there wasn't any nodule in the thyroid.