Clinical presentation. A 38-year-old woman was referred for evaluation of a multinodular goiter. We met the patient nine years ago when she was euthyroid. At this time the thyroid was echonormal with a 10% echogenicity index, the aTPO level was 92 U/mL. We suggested yearly TSH determination.

Palpation: Both lobes were firm.

Laboratory tests: TSH 5.89 mIU/L, aTPO exceeded 1300 U/mL.

Ultrasound. The thyroid was echonormal and contained numerous smaller and larger discrete hypoechogenic lesions with irregular shape and borders.

Aspiration cytology from a hyperechogenic lesion resulted in Hashimoto's thyroiditis.

Comment. The lesions presented in these case are very likely not nodules in pathological sense.