The thyroid is moderately hypoechogenic. In the left picture, we can see several circumscribed areas within the lobe. The echostructure of the dorsal one does not differ from the other lesions, but it contains hyperechogenic granules. This lesion contains two groups of small hyperechogenic granules with dorsal acoustic shadow demonstrated in the right image. This lesion is proved to be the largest focus of a multifocal papillary microcancer in Hashimoto's thyroiditis.