Abstract： To the editor:A 57-year-old Chinese man was found to have multiple thyroid nodules by thyroid ultrasoundgraphy one year ago.The patient felt discomfort when swallowing since five months ago and a weight loss of 7 kg in five months.He denied any history of radiation in head and neck,and no family history of thyroid cancer and other endocrine disease.An enlarged thyroid and two hypoechoic nodules measuring about 17 mm × 11 mm and 6 mm × 5 mm in the right lobe with ill-defined boundary,inhomogeneous parenchyma and hyperechoic spots inside were detected by ultrasoundgraphy.Some hypoechoic,well-defined and enlarged lymph nodes were detected in both sides of the neck.