Clinical data: A 62-year-old woman was referred for aspiration cytology. She has been known harboring a thyroid nodule for a year when she underwent on PET CT scan and neck ultrasound because of breast carcinoma. The former did not reveal thyroid abnormality while the latter did it.

Palpation: There was a very firm nodule in the left lobe.

Functional state: euthyroidism with TSH 0.79 mIU/L.

Ultrasonography. The thyroid was echonormal. There was a minimally-moderately hypoechogenic nodule in the ventral part of the left lobe. The lesion presented a somewhat irregular, partly blurred partly lobulated margin.

A suspicious pattern was found on aspiration cytology. Wash-out thyroglobulin resulted in > 478 ug/dL level.

Our final diagnosis was suspicion of thyroid carcinoma.

Histopathology disclosed papillary carcinoma corresponding to the nodule in the left lobe. A focal lymphocytic thyroiditis was also described.