Clinical presentation: a 67-year-old woman was presented on a follow-up examination with a nodular goiter known for decades. She noticed a lump above the thyroid for 2 months. It was painless.

Palpation: the left thyroid was enlarged with a moderately firm nodule. Above the left lobe there was a firm palpable mass.

Functional state: euthyroidism (TSH 0.38 mIU/L, FT4 14.1 pM/L).

Ultrasonography: there was a moderately hypoechogenic-hyperechogenic nodule in the left lobe. The nodule displayed halo sign and perinodular blood flow. A hypoechogenic lesion was detected above the thyroid. It met the criteria of a benign, reactive type lymph node: it was homogeneous, the hilum was intact and well-seen and the vascularization was not irregular.

Cytology: was performed and resulted in a benign colloid goiter and a benign reactive lymphoid pattern, the thyroid and the lymph node, respectively.