Clinical data: A 54-year old woman was referred for an evaluation of a thyroid nodule in the left lobe discovered by herself. She felt pain radiating to the left ear.

Palpation: a small firm nodule in the right lobe while a tender, elastic large nodule in the left thyroid.

Functional state: euthyroidism with subnormal TSH (0.17 mIU/L) and normal FT4 (17.2 pM/L).

Ultrasonography. There was an echonormal nodule with eggshell calcification in the right lobe. This nodule presented coarse calcifications and intranodular blood flow. There was a large cystic nodule in the left thyroid. The solid part of the latter lesion presented bright echogenic granules. The origin of the latter was not clear, but they probably were back wall figures caused by posterior enhancement.

Cytology was performed from both nodules. Images demonstrated arose from the nodule in the right lobe.

Cytological diagnosis from the left nodule: follicular tumor with less than the average risk of malignancy.

Cytological diagnosis from the right nodule: not diagnostic, cystic degeneration from 11 ml brown fluid.

The evacuated cyst recurred the day after the examination.

Histopathological diagnosis.  Follicular adenoma (right thyroid). Follicular adenoma with regressive changes (left thyroid).