Clinical presentation: A 49-year-old woman was referred for follow-up evaluation of hypothyroidism has been known and treated for several years.

Palpation. No abnormality.

Laboratory test: TSH 4.95 on daily 125 microgram levothyroxine.

Ultrasonography. The thyroid was moderately hypoechogenic and displayed fibrotic changes and more hypoechogenic areas.

 

 

 

 

 

 

 

 

 

.