Clinical presentation: A 45-year-old woman was examined because of weight gain. On ultrasound Hashimoto's thyroiditis and multiple hypoechogenic nodules were described.

Palpation: The right lobe was firm on palpation.

Laboratory tests: TSH 4.08 mIU/L, aTPO 708 U/mL.

Ultrasound. The right lobe and the isthmus had multiple discrete hypoechogenic areas within an echonormal background. The echogenicity index was above 70% in the right lobe. The discrete lesions had partly blurred, partly puzzle-like borders. The entire left lobe was hypoechogenic.

Aspiration cytology from a hypoechogenic lesion resulted in Hashimoto's thyroiditis.

Comments.

1. The lesions presented in this case are very likely not nodules in pathological sense.
   

2. The discrete lesions of Hashimoto's thyroiditis display partly blurred, partly spiculated margins.