Compare the left and right images. Histologically verified Hashimoto's thyroiditis is demonstrated on the left, while histologically proven coexisting papillary cancer and Hashimoto's thyroiditis on the right. The cytological pattern is very similar in these cases. Inclusions which are the most specific signs of papillary cancer are found on the left smears, in the case of Hashimoto's thyroiditis. Lesions with oxyphilic metaplasia mean the most important limitation of nuclear inclusion as a diagnostic tool. In contrast with non-metaplastic cells, which only rarely contain inclusion, in the case of oxyphilic cells the presence of inclusion is absolutely not an infrequent finding. Although it was not a great task to avoid false diagnosis of papillary cancer because the patient had no nodule, the example demonstrated here emphasizes the need for a new approach in the diagnosis of thyroid diseases. Even in less equivocal cases, the cytolopathologist has to give the diagnosis of suspicion of papillary cancer, while if we consider other facts, most importantly the result of ultrasound, the patient will be able to avoid an absolutely unnecessary surgical procedure. As a result, we prefer to give a combined sonographic-clinical-cytologic diagnosis in such cases.