Clinical data: a 48-year-old woman with a thyroid nodule discovered by her family physician on a routine examination.

Palpation: a multinodular goiter.

Functional state: euthyroidism (TSH 2.91 mIU/L).

Ultrasonography: a multinodular goiter. The nodule presented in the images was located in the dorsal part of the right lobe. It was composed of hypoechogenic and echonormal parts and exhibited increased intranodular blood flow.

Cytological picture: the presence of colloid was equivocal. Thyrocytes in non-specific groups. A great proportion of follicular cells exhibit oxyphilic metaplasia. Follicular cells present neither prominent nucleoli nor significant atypia. The possibility of a Hürthle-cell tumor cannot be excluded on cytology.

Cytological diagnosis: suspicion of a Hürthle-cell tumor.

Histopathology: benign hyperplastic nodules. Chronic lymphocytic thyroiditis in the extranodular part of the thyroid.

Comment. I think that our original diagnosis was a failure. First, there is no cytological sign of a papillary carcinoma. Second, the sonographic pattern practically excludes the possibility of an oxyphilic variant of a follicular tumor because of the lack of a halo sign and perinodular blood flow. We should give a common cytological-sonographic diagnosis of a benign nodule with oxyphilic metaplasia.