Chronic lymphocytic thyroiditis - Case 5. (ultrasonographic picture 1)

Right lobe, horizontal view. A hypoechogenic thyroid with fibrotic changes. There is a thin echonormal rim in the dorsal part of the lobe which corresponds to intact thyroid not influenced by thyroiditis. The former investigator interpreted this pattern as a large nodule with irregular borders containing microcalcifications. In fact the puzzle-like border is a very specific sign of lymphocytic thyroiditis. While small puntate hyperechogenic granules correspond to fibrotic tissue running perpendicular to the ultrasound wave.