There is a hypoechgenic lesion in the central part of the left lobe. At first sight, this lesion seems to be a nodule in a pathological sense. On the other hand, there are arguments against this possibility. Firstly, the borders of the nodule are partly blurred (green arrows), partly puzzle-like (red arrow). The former property may favour the possibility of a papillary cancer, while the latter favours Hashimoto's thyroiditis. Secondly, there are several other smaller hypoechogenic areas marked vith blue arrows outside the nodule-like lesion. Thirdly, the fibrotic changes within the lesion is also a (not very strong) argument for the possibility of lymphocytic thyroiditis.

To summarize: we cannot decide solely on the sonographic pattern whether this lesion is a nodule in pathological (oncological) sense or a larger focus of lymphocytic thyroiditis. FNAC is mandatory. Cytology disclosed Hashimoto's thyroiditis.