Clinical data: a 48-year-old woman requested a thyroid evaluation. She was diagnosed with a low grade, stage III/A non Hodgkin lymphoma two years ago. On the first and subsequent PET CT scan no progression was detected and on all occasions multiple foci were described within the thyroid. The patient hasn't got any therapy yet.

Palpation: both thyroids were a bit firm but no discrete lesions could be palpated.

Laboratory tests: TSH 1.56 mIU/L, anti-TPO 0 U/mL.

Ultrasonography: the thyroids were echonormal and contained multiple inhomogeneous, partly blurred hypoechogenic and moderataly hypoechogenic discrete lesions. Multiple lymph nodes were found on both sides of the neck.

Cytology was performed from 3 different thyroid lesions and resulted in a pattern corresponding to non Hodgkin lymphoma.