Clinical data: a 69-year-old woman was referred for evaluation of a nodular goiter. The patient had been treated for hypothyroidism sor 3 years. Four months prior to present investigation she underwent cardiac by-pass curgery when an enlarged nodular goiter was discovered causing stricture of the trachea.

Palpation: both thyroid were nodular on palpation.

Hormonal evaluation indicated euthyroidism on daily 50 microgram levo-tiroxine (TSH 2.53 mIU/L).

Ultrasonography. The thyroid was minimally-moderately hypoechogenic and was composed of multiple discrete areas. The right lobe presented a micronodular pattern and contained one lesion suspicious of nodule in a pathological sense. The right thyroid contained multiple nodules, one of them located in the middle part was moderately hypoechogenic.

Cytology was performed form the moderately hypoechogenic nodule and resulted in benign lesion.

Considering the stricture of the traches surgery was advised.

Histopathology: Hashimoto's thyroiditis in both lobes. Hyperplastic nodules in the left thyroid.

Comments.

1. It is worth to compare the thyroid lobes: the right did not proved to be containing nodule is a pathological senset while the left did.

2. The cytological pattern corresponds to a mixture of Hashimoto's thyroiditis and colloid goiter.