Clinical presentation: a 40-year-old man was referred for an evaluation of a moderately elevated TSH-level detected for 5 years. He had no complaints.

Palpation: both thyroids were firm on palpation.

Functional state: subclinical hypothyroidism (TSH 5.08 mIU/L, FT4 15.5 pM/L).

Ultrasonography: the thyroids were hypoechogenic inhomogeneous and displayed fibrotic changes. There were several echonormal areas in both lobes. One of them in the right thyroid contained hyperechogenic granules.

Cytology: was performed from the above described lesion and resulted in Hashimoto's thyroiditis.

Comment: we use the term of nodule in a pathological sense. The term nodule has to be avoided if we have any doubt whether a lesion is a nodule or only a more active focus of thyroiditis; or conversely one of the few intact areas of the thyroid not influenced by thyroiditis.