Clinical data: A 60-year-old woman referred for aspiration cytology. She has been known to have a thyroid nodule for 2 years. Aspiration cytology was repeatedly non-diagnostic.

Palpation: a firm nodule in the isthmus.

Functional state: euthyroidism with TSH 3.07.

Ultrasonography. The thyroid was echonormal. Both lobes contained several discrete lesions and nodules without any oncological significance except for a relatively large hypoechogenic nodule in the isthmus and a smaller nodule in the left lobe. The former presented intranodular fibrosis and an increased intranodular blood flow while the latter did both microcalcifications and coarse calcifications.

Cytology of the nodule in the isthmus resulted in papillary carcinoma.uha

Histopathology disclosed papillary carcinoma and hyperplastic nodules, isthmus and other lesions, respectively.