Clinical presentation: a 36-year-old woman was referred for an evaluation of a nodular goiter discovered on screening.

Palpation: two nodules were palpable in the left lobe.

Functional state: euthyroidism with TSH-level 3.85 mIU/L.

Ultrasonography: the right thyroid was echonormal. There was a moderately and a minimally hypoechogenic nodule in the left thyroid. The former displayed a type 3, the latter did a type 2 vascular pattern.

Cytology: was performed from the moderately hypoechogenic nodule and resulted in the suspicion of papillary carcinoma.

Histopathology: disclosed benign, hyperplastic nodules.

Comment: we have found cytological signs referring to a tumor. These were the presence of grooves, oxyphilic metaplasia and prominent nucleoli. It is possible that the case would belong to a type 3 category of Bethesda system, i.e. to atypia of unknown significance.