Clinical presentation: a 33-year-old man was referred for evaluation of a minimally elevated TSH-level detected on routine blood test. He had no complaints.

Palpation: both thyroids were firm on palpation.

Functional state: TSH 4.18 mIU/L, FT4 18.2 pM/L, aTPO 894 U/mL.

Ultrasonography: the thyroid presented the so-called honey-combing pattern: the proliferation of connective tissue divides the hypoechogenic thyroid into smaller areas.

Diagnosis: Hashimoto's thyroiditis.

We offered yearly TSH-determination.

Comment: it is to be avoided to overrate the relatively larger hypoechogenic areas as nodules.