Clinical data: A 37-year-old man was referred for aspiration cytology of a thyroid nodule. The was discovered on evaluation of hoarseness that has been lasted for 3 months. No cause for the hoarseness has been revealed.

Palpation: a not firm nodule in the isthmus.

Functional state: euthyroidism (TSH 0.91 mIU/L).

Ultrasonography. The thyroid was inhomogeneous. There was a moderately hypoechogenic nodule in the isthmus which presented halo sign and a combined peri- and intranodular blood flow.

Cytology resulted in papillary carcinoma.

Histopathology disclosed papillary carcinoma.