Clinical presentation: A 35-year-old woman was referred for evaluation of a nodule discovered on screening.

Palpation: The thyroid was not palpable.

Hormonal investigation: subclinical hypothyroidism (TSH 1.86 mIU/L, FT4 15.3 pM/L, aTPO 107 U/mL).

Ultrasonography revealed a minimally hypoechogenic, inhomogeneous thyroid. There was a more hypoechogenic lesion in the left lobe presenting both echogenic lines and granules.

Aspiration cytology: Hashimoto's thyroiditis.

Comment. It is doubtful whether this lesion is a pathological nodule or not.