A 63-year-old woman with a 2.0-cm left thyroid lobe nodule.The ultrasound image shows a solid hypoechoic nodule with incomplete rim calcification (short arrows) and suspicious ultrasound features of nonparallel orientation (taller than wide) and microcalcification (punctate echogenic foci) (long arrow), as well as multiple large echogenic foci. Findings from repeated ultrasound-guided fine-needle aspirations were nondiagnostic and core needle biopsy revealed benign follicular nodule with degeneration. A follow-up ultrasound performed 9 years after the initial fine-needle aspiration showed no change in the size of the nodule.