Clinical presentation: A 50-year-old woman was referred for evaluation for a nodular goiter. She had typical complaints suggesting hypothyroidism. The TSH was elevated. On ultrasound a multinodular goiter was diagnosed with "a large, highly suspicious nodule with lobulated margins" in the right lobe.

Palpation: Both thyroids were firm. No discrete nodule could be palpated.

Hormonal investigation: hypothyroidism with TSH 22.5 mIU/L.

Ultrasonography: The right lobe was composed of partly relatively well-demarcated, partly confluencing hypoechogenic areas. The left lobe presented the so-called micronodular pattern of Hashimoto's thyroiditis.

Cytological diagnosis: Hashimoto's thyroiditis.

Comment. Hashimoto's thyroiditis can present practically any form of hypoechogenic areas. The pattern even in the right thyroid corresponds to micronodular form of Hashimoto's thyroiditis.