Chronic lymphocytic thyroiditis - Figure 6. Hyperechogenic figures in Hashimoto's thyroiditis. Hyperechogenic figures within a hypoechogenic discrete lesion are most frequently microcalcifications, comet-tail artefacts or fibrosis. The latter is the most frequent possibility in the event of Hashimoto's thyroiditis. It is characterized by the presence of both punctate granules and hyperechogenic lines. Coarse calcifications may occur in Hashimoto's thyroiditis, as well.

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Intense fibrosis is demonstrated.
A suspicious lesion is demonstrated with microcalcifications. The lesion proved to be benign.
The ventromedial hypoechogenic nodule with microcalcifications proved to be a papillary carcinoma. Note less hypoechogenic discrete areas elsewhere in the thyroid.
The dorsal more hypoechogenic nodule presenting coarse calcifications proved to be a papillary carcinoma.