Clinical presentation: a 64-year-old woman requested evaluation of 'lump in the throat' feeling. We examined her 8 years ago when a multinodular goiter was found and cytology was benign.

Palpation: a multinodular the right lobe.

Functional state: euthyroidism with TSH 0.29 mIU/L, FT4 15.1 pM/L.

Ultrasonography. The thyroid was echonormal. There were two lesions in the right lobe, the upper was a minimally hypoechogenic and had bright hyperechogenic figures and non-.specific granules. The lower lesion was a multi-chambered cyst with echonormal solid area. This nodule contained larger linear and granular hyperechogenic figures corresponding to connective tissue. None of the nodule has increased since the first visit.

Comment.

1. Although the bright hyperechogenic granules in the upper nodule might correspond to microcalcifications, the ultrasound presentation of the nodule is not suspicious.

2. The thick hyperechogenic figures in the lower, larger nodule are relatively unusually presentations of connective tissue.