Clinical data: a 52-year-old woman was referred for an evaluation of newly discovered multiple nodules. She was treated for hypothyroidism for 15 years.

Palpation: no abnormality.

Functional state: euthyroidism on daily 112.5 microgram levothyroxine.

Ultrasonography: a hypoechogenic thyroid with extensive fibrosis. Typical presentation of the so-called pseudonodular form of Hashimoto's thyroiditis.

Comment: it is very important to avoid the term "nodule" in such patterns. These circumscribed areas mimic multinodular goiter, but in truth these are discrete areas divided by fibrosis.